Advanced School of Banking - Year 1 Application

September 25 - 29, 2023 ~ Kearney, NE

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* 1. Enter your Contact Information

Full Name (as you wish it to appear on diploma)

Nickname (for badge)

Last Name

Bank Name

Bank P.O. Box and Street Address

City

State

ZIP

Bank Phone Number

Attendee Cell Phone Number

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* 2. Additional information

Attendee Work Email *

Attendee Personal Email (in case attendee can't access email outside of office while at school as testing/evaluations are done by email)

Main Bank Name (if different)

Main Bank Address (if different)

In case of emergency, contact (Name & Phone Number) *

Roommate Request, if Applicable (Name and Bank)

Job Position/Title *

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* 3. Enrollment Fee - Upon acceptance into the School, registrants will be invoiced by email for the applicable enrollment fee approximately two weeks before the School. Nonmembers of their State Banking Association must pay an additional fee of $950.

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* 4. Total Assets of Your Organization

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* 5. Total Years Financial Services Experience

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* 6. ABA Training or College Courses Completed

Other (please specify)

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* 7. Rank your THREE major areas of experience (ONLY CHOOSE THREE; 1=area you've had most experience; 2=area you've had some experience; 3=area you've had least experience)

	1	2	3
Lending	Lending 1	Lending 2	Lending 3
Loan Administration	Loan Administration 1	Loan Administration 2	Loan Administration 3
Compliance	Compliance 1	Compliance 2	Compliance 3
Operations	Operations 1	Operations 2	Operations 3
Investments	Investments 1	Investments 2	Investments 3
Asset/Liability Management	Asset/Liability Management 1	Asset/Liability Management 2	Asset/Liability Management 3
Public Relations	Public Relations 1	Public Relations 2	Public Relations 3
Human Resources	Human Resources 1	Human Resources 2	Human Resources 3
Customer Service	Customer Service 1	Customer Service 2	Customer Service 3
Business Development/Sales	Business Development/Sales 1	Business Development/Sales 2	Business Development/Sales 3
Personal Trust	Personal Trust 1	Personal Trust 2	Personal Trust 3

Other (please also specify 1, 2, or 3)

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* 8. Educational Background:

Please specify college major if applicable:

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* 9. Enrollment Agreement: I have read the School brochure and agree to abide by assigned housing arrangements and all requirements for completion of this School. I consent to the release of grades and other performance measures to my employer.

Applicant Name

Nominating Officer Name

Nominating Officer Title

Nominating Officer Email Address