VOMI Global Think Tank Advisory Board - Request Distinguished Global Ambassador Invitation

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Global Think Tank & Advisory Board

Request
Distinguished GlobalAmbassador
(Honorary Board Member)
Invitation

General Information

Fields required. *

Today's Date*

MonthDayYearHourMinutes

Full Name*

First NameMiddle NameLast Name

Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

SmartPhone Number*

Area CodePhone Number

Your Email*

Confirmation Email

Corporate, Government & Academia Profile Information

Are you currently a full-time government employee or member of the military?*

YesNo

Specify your government or military function or assignment*

Your Military Rank*

Do you currently hold a Security Clearance?*

YesNo

Level of Security Clearance*

Are you currently a member of academia?*

YesNo

Current Full-time Employer*

Current Job Title*

Official Website*

Social Media Profile Information

LinkedIn Profile*

Other Social Profile #2

Optional

Your Photo*

Upload Resume

For cybersecurity reasons.

Global Think Tank Advisory Board Participation Information

Reason for wanting to serve as Distinguished Global Ambassador*

Upload Reason

Country of Interest*

Personal References

Name of Personal Reference #1*

Reference #1 Email*

Confirmation Email

Name of Personal Reference #2*

Reference #2 Email*

Confirmation Email

Global Think Tank Advisory Board Member Referral Information

Who Referred You to VOMI?*

How did you hear about us?

Name of VOMI Executive in Email Promotion*

First NameLast Name

Name of VOMI Global Ambassador*

First NameLast Name

Name of LinkedIn Contact*

First NameLast Name

Name of Facebook Contact*

First NameLast Name

Name of XING Contact*

First NameLast Name

Name of Ning Contact*

First NameLast Name

Name of ResearchGate Contact*

First NameLast Name

Name of Other Social Network Contact*

First NameLast Name

Name of Friend or Associate*

First NameLast Name

Name of Job Board or Career Site*

Name of Ning Group*

Name of LinkedIn Group*

Name of Facebook Group*

Name of XING Group*

Name of ResearchGate Group*

Name of Other Social Network Group*

Name of Other Search Engine*

Authorization to verify application information

You hereby acknowledge that your submission of this application constitutes authorization to Virtual Organization Management Institute (VOMI) et al to verify the information herein provided.

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