2023 CAA Board of Directors Nomination Application The following information is for internal Nominations Committee Review Only Question Title * 1. For petitions, please select "Yes, I am nominating myself" for the question below. Yes, I am nominating myself No, I am nominating someone else Question Title * 2. Nominator’s Full Name Question Title * 3. Nominator’s Email Address Question Title * 4. Nominee's full name Question Title * 5. Nominee's email address Question Title * 6. Nominee's phone number Question Title * 7. If you were referred to apply for a Board position, please list their name(s) Question Title * 8. As a Board Director, we request that you make an annual financial gift supporting Caltech. Are you comfortable with making a gift of any amount? The gift can be directed to any area of the Institute. Yes, I already donate regularly to Caltech Yes, I will donate while I serve on the Board No, I do not plan to donate to Caltech Question Title * 9. All USA residing Directors of the Board are expected to attend 1 meeting quarterly (2 in person per year and 2 virtual), in addition to monthly committee meetings. Board members should also participate when possible, in Alumni Association events and make an annual financial contribution to Caltech. Please provide a statement that you, the nominee, are prepared to commit to CAA Board activities both by video conference and in person and can travel to attend face-to-face meetings approximately two times annually. Question Title * 10. Professional CV or resume, limited to 5 pages (PDF preferred) PDF file types only. Choose File Choose File No file chosen Remove File Professional CV or resume, limited to 5 pages (PDF preferred) Question Title * 11. Examples of current and/or past engagement with CAA groups or events (CAA specifically, as opposed to Caltech) [limit 50 words] Engagement: Engagement: Engagement: Engagement: Question Title * 12. Examples of current and/or past engagement with Caltech groups or organizations [limit 50 words] Engagement: Engagement: Engagement: Engagement: Question Title * 13. Statement of Interest describing the nominee’s interest in and qualifications for serving on the CAA Board [limit 350 words] Question Title * 14. Any additional info you feel is relevant to the nominations process [limit 100 words] (optional) The following information is for the public ballot and website materials Question Title * 15. Board Nominee Name with preferred spelling and appropriate degree designations as it should appear on the slate, if selected. E.g., Robin Beaver, Ph.D. Question Title * 16. Current professional title and name of employer Question Title * 17. Current residence of city, state, and country (if outside the U.S.) Question Title * 18. Headshot with print-quality resolution (300 dpi or higher) PNG, JPG, JPEG, GIF file types only. Choose File Choose File No file chosen Remove File Headshot with print-quality resolution (300 dpi or higher) Question Title * 19. Candidate platform information, identifying opinions on priorities and issues facing CAA, ideas for technical activities, and suggestions for business development initiatives or strategic partnerships. [limit 250 words] Done