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2027 Board of Directors Application
Please refer to the
board member qualifications, terms
and
ACN bylaws
before applying:
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1.
Name:
(Required.)
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2.
Agency/Brokerage:
(Required.)
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3.
Job Title:
(Required.)
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4.
What's your primary responsibility within the agency/brokerage? Where do you spend your time?
(Required.)
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5.
City:
(Required.)
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6.
State/Province:
(Required.)
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7.
Country:
(Required.)
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8.
Is your agency/brokerage part of a larger company/franchise? If so, please list the company/franchise name. If not, enter N/A.
(Required.)
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9.
Have you reviewed the member qualifications/time commitment and confirmed your employer’s support for serving on the ACN board?
(Required.)
Yes
No
Other (please specify)
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10.
Are you prepared to meet the expectations of your role on the Board for the entire three-year term and to the best of your knowledge, will your agency/brokerage remain an Applied customer for the duration of your Board tenure?
(Required.)
Yes
No
Other (please specify)
*
11.
Are you able to travel a minimum of three times a year for Board related trips within the US and Canada?
(Required.)
Yes
No
Other (please specify)
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12.
Individuals who actively provide consulting services or are employed by a third-party vendor are not eligible to serve on the Board of Directors per the ACN bylaws. Please select one:
(Required.)
I do not currently provide consulting services and am not employed by a third-party vendor.
I do currently provide consulting services or am employed by a third-party vendor but understand that I must cease such services during any board service.
I currently provide consulting services or am employed by a third-party vendor and do not intend to cease such services if selected.
Other (please specify)
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13.
Have you applied for an ACN board seat in the past? If so, please list the year you applied. Also, please note if you were interviewed.
(Required.)
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14.
How many years have you (individual) been an Applied Client Network member?
(Required.)
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15.
Please indicate which Applied products you currently use and note any product changes you anticipate.
(Required.)
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16.
How many Applied licenses does your agency/brokerage have?
(Required.)
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17.
List one or two professional experiences that you believe best prepared you to contribute as a potential board member of ACN. Briefly describe your role, the level at which you operated (e.g., contributor, leader, executive), one result or impact you are particularly proud of and insight you gained through the experience.
(Required.)
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18.
Describe a situation where you influenced or informed a technology, data, or systems decision. What was your role and what perspective did you bring?
(Required.)
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19.
Share a leadership moment that shaped how you advise or influence others today. What did you learn about your values and/or judgment?
(Required.)
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20.
Describe your experience and/or approach in working collaboratively with others.
(Required.)
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21.
Describe a strategic issue you were involved in, appropriate to your role at the time. What tradeoffs were considered and how did you contribute?
(Required.)
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22.
In your opinion, what are the two biggest challenges facing Applied Client Network and/or the insurance industry over the next five years? What strategic direction do you think ACN should take to face those challenges?
(Required.)
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23.
What is your relationship with Applied Systems employees and products in your current role? How do Applied Systems products play into the strategic direction of your company as a whole?
(Required.)
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24.
Please share how you interact or engage as a member of Applied Client Network. Please detail which member benefits you use/participate in (ie. in-person or virtual meetings/events, online communities, webinars, website, presenter opportunities, mobile app etc). Please also list any present or past experience as an Applied Client Network volunteer/leader including dates of volunteer service, education/training contributions etc.
(Required.)
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25.
Please list any other volunteer experiences you have held or leadership positions you have served (ie. board/committee positions) outside of Applied Client Network.
(Required.)
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26.
What is your interest and vision for Applied Client Network and its Board and what do you believe you can offer by becoming a member of the Board? Please also share one area you are interested in learning more about as a board member.
(Required.)
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27.
Provide any additional information you feel might be relevant to your candidacy for the Applied Client Network Board.
(Required.)
