CBCF Alumni Directory Form
CBCF Leadership Institute Alumni,

Please complete the following form to the best your ability. The information you provide will help us shape our Alumni membership efforts, events, and communications. 

Be sure to join our Alumni LinkedIn group to stay connected.
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First Name *
Last Name *
Preferred Contact Email *
Current City *
(i.e. Charlotte, Atlanta, Chicago)
Current State *
(i.e. MD, GA, FL)
Zip Code *
(i.e. 20005)
Which CBCF program did you participate in? *
(Select all that apply)
Required
In what year did you participate? *
(i.e. 2008)
If you were a CBCF Intern, were you a State Farm Communications, Walmart Emerging Leaders, or C-Suite Intern?
 *
If you were a CBCF Fellow or Intern, what office, committee or corporation were you placed with?
 *
(i.e. Representative Joyce Beatty or N/A)
If you were a CBCF Scholarship Recipient, what scholarship did you receive? *
(i.e. CBC Spouses Education Scholarship or N/A)
What school(s) did you attend?
 *
What is your current role and title?
 *
Are you a member of any of the following organizations?
Outside of your primary career field, what fields of work do you have experience in?
 *
Select all that apply.
Required
Please list any other previous roles and/or titles that you would like to share with the Alumni Team.
Please list any hobbies, areas of interest, volunteer work, etc.
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