* 1. Address

* 2. Do you serve as a columnist for anyone else?

* 3. If yes, please indicate the publications:

* 4. Please confirm you understand you are applying for a monthly columnist slot through December 2017:

* 5. Please provide a short description of your column and the topics it will include (i.e. ethics, accountability and performance, personnel management, social equity, etc.)

* 6. Please upload an appropriate writing sample to this form.

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