Aero MAR B.E.C. Member Registration Form

Aero MAR Black Excellence Council

MEMBERSHIP REGISTRATION
B.E.C. is rebranding and we'd like to have more insight on our membership. To do so, we are asking all existing and new members to complete this form to assist us in identifying our membership and their interests.
Business Area:
Work Location:
Name

PrefixFirst NameLast NameSuffix
Home Mailing Address:

Street Address

Street Address Line 2

CityState

Zip Code
Job Title:
Work E-mail:
example@lmco.com
Personal E-mail:
example@example.com
Work Phone Number:
Format: (000) 000-0000.
Personal Mobile Number:
Format: (000) 000-0000.
Do you authorize B.E.C. to add the personal mobile number above to GroupMe

Aero MAR Black Excellence Council

MEMBERSHIP REGISTRATION
B.E.C. is comprised of individuals with various interests. In an effort to improve member engagement in professional, social, and volunteer/recruiting functions, we ask for suggestions on events, as well as, feedback.
Professional Events:
Social Events:
Volunteer Events:
Feedback:
Are you interested in being a moderator/panelist/couch guest?
If so, what topics of interest would you like to participate in:
Should be Empty:

Aero MAR Black Excellence Council