BOARD OF DIRECTORS PROFILE SUBMISSION FORM

As a newly appointed member of the EMPACT International Board of Directors it is imperative and mission critical that we gather certain information from all of our board members. Please complete the below form and submit it.

PRIVATE INFORMATION SECTION:

All information in this section to exclude your first and last name will be kept private and will not be shared at any time with the public with your expressed and documented permission.

APPLICATION FOR:

Please tell us which position are you applying for.

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PUBLIC INFORMATION SECTION:

All information gathered in this section will be posted on the EMPACT International public website and will be viewable by the public. Please do not submit any information that you do not want to be made public.

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Choose your desired committee. Selecting a committee does not guarantee appointment to that committee. Committee appointments are based on area of expertise and the needs as determined by the Board of Directors.
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Thank you for your service to EMPACT International and the global community