Nominee Form

Thank you for your interest in the 2020 HBA NE Region Executive Exchange program, a selective program open to female and male executives in the life sciences industry.
 
Before completing this nomination form, please ensure that you meet the following Executive Exchange participant criteria:
  • Female or male leader in a healthcare or life science company (not a service provider)
  • Currently holds a C-suite, SVP, or VP role; if VP role then must have 1+ year experience
  • Has significant responsibility for strategic / operational decisions, direct reports and budget accountability
  • Are committed to:
    • Your own career advancement
    • Helping advance other women’s careers
    • Attending 7 monthly events between February and September 2020 including the mandatory kick-off event scheduled for February 4, 2020 (at Osteria Posto in Waltham); please ensure you understand and are committed to meeting this requirement
About the Executive Exchange Nomination:

  • Nomination submissions are being accepted now through November 25, 2019, though we reserve the right to close nominations early if we reach program capacity with qualified candidates.
  • Nominees will be notified of their program status on or before  December 2, 2019.
  • Nominees accepted into the program will not exceed one per company per roundtable.
  • Sources of nominations include: HBA corporate partners, HBA NE company sponsors, HBA NE regional council / volunteers, and self-nominations.
  • Nomination Submissions are recorded by date and time of completion which could become relevant should there be more qualified nominees than there are roundtable placements.
  • The Executive Exchange committee’s goal is to create optimal roundtable groups based on nominations for candidates who satisfy all participant criteria.

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* 1. CONTACT INFORMATION

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* 2. BACKGROUND INFORMATION

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* 3. List last 3 companies where you have worked

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* 4. Education: Please denote the schools(s) and degree(s) attained

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* 5. Are you actively supporting aspiring female leaders in their career progression? Please provide examples: mentoring, company programs, etc...

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* 6. Why are you interested in participating in the HBA Executive Exchange Program?

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* 7. Time commitment :  For the program to be successful, it is critical that ALL participants understand and commit to full participation in all events, except in rare unforeseeable circumstances.


The 7-month Executive Exchange Program requires preparing for and participating in one event monthly for seven months between February and September 2020 including:
  • 2 Large group events: February 4, 2020, and September, 2020
  • 5 intimate roundtables: March through July
 Are you committed to attending the above meetings?

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* 8. If yes, please let us know what do you want to achieve from the Executive Exchange experience?

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* 9. Who will cover the cost of the Executive Exchange participant fee of $1450?

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* 10. Is your company interested in exploring company sponsorship opportunities for Executive Exchange? If so, whom in your organization should HBA NE connect with?

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