2021 CSA Board of Directors - Candidate Information Form

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* 1. Name:

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* 2. Credentials (i.e. PhD, PE, etc.):

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* 3. Company/Organization:

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* 4. Job Title:

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* 5. Email:

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* 6. Phone:

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* 7. Professional Bio - 150 Word Limit (Note: This will appear on the ballot)

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* 8. Headshot (for use in publications and website if elected)

PNG, JPG, JPEG, GIF file types only.