Contact
Name
*
Prefix
First name
Last name
Suffix
University/College or Employer
*
Major
*
I am a...
*
Sophomore
Junior
Senior
Graduate Student
NSBE Professional
Expected Graduation Date
*
-
Month
-
Day
Year
Date
E-mail
*
Phone Number
*
-
Area Code
Phone Number
Headshot
*
Please ensure a high resolution photo is uploaded
Declaration of Intent
I am interested in becoming the:
*
Please Select
Regional Chairperson
Regional Vice-Chairperson
Regional Secretary
Regional Treasurer
Regional Finance Chairperson
Regional Publications Chairperson
Regional Public Relations Chairperson
Regional Membership Chairperson
Regional International Chairperson
Regional Programs Chairperson
Regional PCI Chairperson
Regional Academic Excellence Chairperson
Regional Parliamentarian
Regional Telecommunications Chairperson
Regional Technical Outreach Community Help (T.O.R.C.H.) Chairperson
Regional Leadership Conference (RLC) Chairperson
Fall Regional Conference (FRC) Chairperson
Have you contacted the person currently holding your position?
*
Yes
No
Why do you want to run for this position?
*
0/400
What are your current or future obligations? How does this position you are applying for add to those?
*
0/400
Nearest Airport Code
*
National Campaign Practices Code
*
I have read and will uphold to the National Campaign Practices Code
Unofficial transcript
*
This should be an unofficial transcript that reflects your current semester in school
Leadership Resume
*
Letter of Recommendation
Enrollment verification
*
This document should reflect enrollment for your current semester in school.
Apply to the Region III Executive Board
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