B-School BossyPants Application

Application for consideration of a broadcast profile review by Betsy Massar & Pamela Jaffe on

B-School BossyPants.

Name*

First NameLast Name

E-mail*

Home number

Area CodePhone Number

Cellular number*

Area CodePhone Number

Which schools are you applying to?*

Anticipated MBA start year?*

Previous applicant?*

YesNo

Post MBA career goals*

Employer history*

Position*

What school was your undergraduate degree?*

What was your major?*

What was your GPA?*

Graduating year*

Graduate school?*

YesNo

GMAT/GRE score*

V%/Q%*

Extracurriculars, leadership, or volunteer experience?*

International experience?*

Positions of two recommendors*

Are you attending the preMBA Networking Festival?*

YesNo

Have you attended a CentreCourt MBA Festival?*

YesNo

If your resume and profile are accepted, are you available for a live review?*

YesNo

Please upload your resume here. This file must be a PDF. Please name file: LastName_FirstName*

Upload a File

Notice of live broadcast:

I, the undersigned, do hereby consent to the use by Poets&Quants, C-Change Media of my image, voice, or both described below, in (1) the video, photograph, or audio recording described in this application form; and (2) any video, photograph, or audio recording reproduced either in whole or in part from the video, photograph or audio recording described in this application form: regardless of whether these materials are used for promotion, printed or electronic publication, advertising, publicity, or any other purpose on behalf of either Poets&Quants or C-Change Media.

I warrant that I have the full right and authority to grant this consent.

In addition, I waive all claims to compensation or damages based on the use of my image or voice, or both, by either Poets&Quants or C-Change Media. I also waive any right to inspect or approve the finished photograph or video or audio recording.

I understand that this consent is perpetual, that I may not revoke it, and that it is binding on me, my heirs and assigns.

I warrant that I am at least 18 years of age and that I am competent in my own name insofar as this consent is concerned. I further attest that I have read this consent form and fully understand its contents.

Signature*

Submission date*

MonthDayYear