Relationship & Business Development School Application

June 23 - 25, 2020 ~ Manhattan, KS

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* 1. Enter your Contact Information

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

Nickname (for badge)

Bank *

Bank P.O. Box and Street Address *

City *

State *

ZIP *

Bank's Phone Number *

Email Address *

Cell Phone Number *

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* 2. Additional information

Main Bank Name (if different)

Main Bank Address (if different)

Last 4 digits of SSN *

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. Nonmembers of their State Banking Association must pay an additional fee of $475.

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* 4. Do you want your curriculum in electronic format only, or do you want printed materials? PLEASE NOTE: If you choose electronic, you must bring a tablet or laptop with your curriculum loaded and ready to go (will be provided in advance of the school) in the classroom. Some materials may still be provided in paper format for class exercise purposes.

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* 5. Total Assets of Your Organization

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* 6. Total Years Financial Services Experience

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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. List your Primary Job Responsibilities:

1.

2.

3.

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* 10. Do you supervise any employees?

Yes

No

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* 11. 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