Employment/Influence

We are interested in including professionals from diverse facets of the marketing, media and tech industry (media & creative agencies, advertisers, research, digital & print publishers, broadcast/cable, ad tech, professional development, public relations and business development).  We are looking to include both those professionals who have already achieved executive management roles, as well as those that are on a clear and/or accelerated path towards executive management.

Executive Class Membership annual fee of $1,500 (paid in full) is required to remain in good standing.

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* 1. Company (please provide website link)

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* 2. Title (Choose one that most closely matches your current title, or write-in your title as it is represented within your company)

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* 3. Role (Select one or more that most closely match your current role, or write-in a description of your role, with respect to your authority, responsibility and leadership)

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* 4. If you are not currently employed, please provide the following information regarding your last employment:

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* 5. What do you hope to experience through Executive Class membership? How would you hope to contribute to the Executive Class membership community?

Industry/Community Involvement (must meet 2+ criteria, please choose all that apply, or write-in your area and focus of involvement)

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* 6. We believe that a responsibility of the professional is to actively participate in the positive development of the communications community. In doing so, we become more valuable to our individual companies; we continue our own professional development; we are role models for professional women of all levels; and we enrich and improve the community as a whole.

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* 7. References (must supply 1; please provide name, company, and contact information)

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* 8. Date Submitted

Date

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* 9. Contact Information

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