Copy of Application Form: Executive Secretary

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Email *

Name *

Street Address: *

City *

State *

Zip *

Home Phone *

Work Phone *

Cell Phone *

Email Address *

Chapter Name *

Member since: *

Chapter Level Offices/Committees/Responsibilities *

State Level Offices/Committees/Responsibilities (If none write "none") *

International Offices/Committees/Responsibilities (If none write "none") *

Qualifications

You have read the job description including qualfications for this position. Please respond specifically to your expertise in each of the following areas. You may include relevant examples of past work.

Time Management/ Prioritizing Skills to Meet Deadlines *

Available Time to Execute Duties and to Attend State, Regional, and International Meetings *

Additional Information: Please share details regarding your professional experience, volunteer work, honors and any additional information that you feel will further demonstrate your qualifications for this position. *

References:

Please list at least two people who are able to verify your qualifications for this position.

Reference 1 Name *

Reference 1 Address *

Reference 1 Phone Number *

Reference 1 Email *

Reference 2 Name *

Reference 2 Full Address *

Reference 2 Phone *

Reference 2 Email *

Thank you for your application.

A copy of your responses will be emailed to the address you provided.