Aspiring Executive Academy (AEA) Nomination Form

Aspiring Executive Academy (AEA) Nomination Form
Thank you for your interest in the Aspiring Executive Academy! If selected, the program tuition is $4,500, which includes full admission into the 2023 Ascend Convention. Program participants are responsible for their own lodging and transportation costs.

Program Criteria: Senior executives that currently hold a VP, SVP or GM role (or equivalent), specializing within an operating vertical, whose next role will be a CXO at a Fortune 1000 or equivalent company.
Nominee Information
Name of Nominee*

First NameLast Name
Title of Nominee*
Company of Nominee*
Years of Experience of Nominee*
E-mail Address of Nominee*
example@example.com
Phone Number of Nominee*
Please enter a valid phone number.
Nomination Type*
Nominator Information: (if applicable)
Name of Nominator *

First NameLast Name
Title of Nominator*
Company of Nominator *
Nominator Relationship to Nominee*
E-mail Address of Nominator*
Phone Number of Nominator*
Please enter a valid phone number.
Nominee Qualifications:
Brief description on why this executive is being nominated:*
What is the aspired next role / pathway (please include 2-3 potential next roles):*
LinkedIn Profile of Nominee*
Attach Bio or Resume *

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Attach a colored/high resolution headshot *

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Other information:
Are you registered for the 2023 National Convention?*

YesNo
If you are registered, please provide your registration # (if known)
Should be Empty:

Nominee Information