ESA Leadership Nominee Information Form

Name

First Last

Email

Your current professional position*

Your employer*

You are a nominee for:*

Please upload your resume/CV, or a biographical statement:

Max. file size: 256 MB.

This document should be both up to date and inclusive of all employment and educational history.

You have prior experience with which of the following?*

Select All
Publications
Education
Public Affairs
Fundraising/Development
Diversity, Equity and Inclusion
Member Services
Finance

Please select all that apply.

Please summarize your previous leadership experience with ESA:*

Maximum 1,200 characters but please be as brief as possible

Please summarize your previous leadership experience outside of ESA:*

Maximum 1,200 characters but please be as brief as possible

Please provide a brief statement on how your combined experiences and interests would provide value to the ESA Governing Board*

Maximum 1,200 characters but please be as brief as possible

Please provide a brief statement on how your combined experiences and interests make you a strong candidate for President-elect*

Maximum 1,200 characters

Please provide a brief statement summarizing your support for ESA's strategic priorities, including diversity, equity and inclusion*

Maximum 1,200 characters

Consent to Nomination*

I acknowledge and accept my candidacy

By checking this box, I acknowledge and accept my nomination to a position with ESA's Governing Board, to take office in 2025. As such, I certify that all of the submitted information is true to the best of my knowledge; that I understand that my current candidacy is pending review by the Nominations Committee; and that my name will only appear on the ballot if I am selected as a final candidate by the Nominations Committee.

Conflict of Interest Acknowledgement*

I acknowledge that I have reviewed ESA's Conflict of Interest Policy

By checking this box, I acknowledge that I have reviewed and accept ESA's Conflict of Interest Policy, and that I would be required to disclose all conflicts on an annual basis, including prior to the start of a term in office.

ESA Leadership Nominee Information

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ESA Leadership Nominee Information Form

ESA Leadership Nominee Information

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