Please tell us a bit about yourself and your interests.

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1. First Name

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2. Last Name

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3. Designation

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4. Organization

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5. Email

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6. LinkedIn Profile

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7. Board of Directors Interest. Please select all that apply.

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8. Committee Leadership Interest. Please select all that apply. GSAE has a Chair/Vice Chair structure.

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9. Statement of Interest*
Briefly describe why you are interested in serving as a GSAE leader.
(Required.)

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10. Recommendation*
Provide specific example(s) of leadership that qualify you to serve as a GSAE leader
(Required.)

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