Alumni Board Interest Form

Henderson State University Alumni Association
Board Interest Form

The deadline to submit an interest form for the upcoming term is January 11, 2013.

A term on the board lasts 3 years unless elected to the office of President, resulting in a 5 year term consisting of President-Elect, President, and Past President. The Alumni Board of Directors meets 4 times per year, January, April, July, and October on Henderson’s campus. You would be expected to attend these meetings. Every member serves on 1 of 3 committees, making recommendations to the board concerning the recipients of awards such as Distinguished Alumni and scholarships, as well as a committee who examines projects that could benefit Henderson and its alumni. Committee meetings normally require one or two meetings a year. In addition, you would be encouraged to attend many events on campus. These are not mandatory, but some are quite rewarding.

If you are interested in serving on the Alumni Board of Directors please submit information in the form below. Entries marked with an asterisk [*] are REQUIRED information. Thank you for your interest.

All Fields Must Be Completed Or Marked N/A

Biographical Information:

Salutation (Click one to select): If 'Other', specify:

*Last Name: *First Name:

*Birth Date: (MM/DD/YYYY): / /

Maiden Name: Former Name:

*HSU Graduation Year: *Major: * Degree:

HSU Graduation Year: Major: Degree:

Name of Spouse: Spouse is an HSU Graduate

References:

Name: Contact information:

Current Home Address:

*Street:

*City: * State: * Zip Code:

*Telephone Number (include area code, without dashes or parentheses):

Cell Phone Number (include area code, without dashes or parentheses):

*E-Mail Address:

Current Business Information:

*Occupation:

Employer:

Street:

City: State: Zip Code:

Work Telephone Number (include area code, without dashes or parentheses):

Work E-Mail Address:

Previous Employment Positions:

Please give exact titles and years in chronological order, beginning with your most recent position.

Employer: Title: From: To:

Facts About Your Career:

Education:

Colleges and Universities Attended other than HSU(Please provide dates of graduation and degrees earned, including honorary degrees):

School: Degree: Year Graduated/Last Attended:

Public Offices Held:

Title: Location: From: To:

Memberships and Offices in Organizations: (Professional, Civic, etc.)

Military Service:

Branch:

Highest Rank:

Type of Duty:

From: To:

Collegiate and Professional Honors and Awards:

*Describe your involvement with Henderson State University and the Alumni Association since graduation:

*List Henderson State University or Alumni functions you have attended in the last five (5) years (i.e. Alumni Gatherings, Homecoming, Theater Productions, Athletic Events, Reunions, etc.):

*Describe your fondest memory of Henderson State University:

CLICK "SUBMIT FORM" BUTTON TO SUBMIT INFORMATION.

Thank you for taking the time to share your information with us!

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