Flinn-Brown Fellows Directory Update Survey

With almost 500 Fellows, there is always a lot happening. We know about some of your achievements and activities but want to capture as many as possible.

NOTE: If you would like to update your headshot, please upload it to this Google Drive folder.

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1. We are making every effort to ensure your records are complete and up to date. For this section, please use your HOME address. (Required.)

Name *

Home Address *

Home Address 2

City/Town *

State/Province *

ZIP/Postal Code *

Preferred Email Address *

Cell Phone Number *

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2. For this section, please provide your MAILING address if it is different from your home address - for example if you use a PO Box to receive mail, enter that here:

Mailing Address

Mailing Address 2

City/Town

State/Province

ZIP/Postal Code

Country

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3. We would love to know your birthday!

MM / DD / YYYY

Date

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4. What is your race/ethnicity (select all that apply)

Asian

Black

Hispanic or Latino/a/x

Native American/Alaska Native

Native Hawaiian/Pacific Islander

White/Causasian

Other (please specify)

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5. Please tell us if you have any past or current military affiliation, including branch and years of service.

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6. What is your voter party registration?

This information is for demographic purposes only. We strive for the Fellowship to reflect Arizona, including political party affiliation statistics, and would like to gather the data necessary to help us measure this accurately.

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7. Tell us about your current place of employment: (Required.)

Name of organization/place of buisiness:

Your current job title:

How long have you been in this role:

If retired, date of retirement:

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8. Tell us about your professional field of work (Choose 1): (Required.)

Arts & Culture

Business & Management

Communications

Education

Environment

Government & Public Affairs

Healthcare

Human Services

Law & Public Safety

Public Administration-Federal

Public Administration-Local

Public Administration-State

Retired or Self-employed

Science & Technology

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9. Tell us about your areas of professional expertise (Choose 3): (Required.)

Accounting

Advertising

Agriculture & Farming

Archeology

Architecture

Arts Management

Bioscience Research

Budget

Children & Families

Civic Engagement

Data Analytics

Digital Media

Economic Development

Education-Early Childhood

Education-Higher Education

Education-PreK-12

Elections Management

Emergency Management

Energy

Engineering

Finance

Forest Management

Government Relations

Health Management

Housing

Human Resources

Immigration

Information Technology

International Trade

Investment Management

Journalism & Broadcasting

Land Management

Law Enforcement

Legal Services

Manufacturing

Marketing

Medicine

Military & Veterans

Natural Resources / Land Management

Nonprofit Management

Performing Arts

Photography

Policy / Legislation / Lobbying

Political Campaigns

Public Affairs

Public Relations

Public Safety

Real Estate

Regulation

Restaurant Management

Small Business

Transportation

Travel & Tourism

Tribal Affairs

Water

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10. What has been new in your professional or civic leadership activities this year? (Check all that apply.)

Ran for state elected office

Ran for local elected office

Appointed to a state board or commission

Appointed to a local board or commission

Appointed to a non-profit board

Not applicable - no changes to report

Tell us about the boxes you checked. Include the name of the office/board/commission as well as relevant dates.

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11. Are you planning on any of the following in the next year?

Run for state level elected office

Run for local level elected office

Apply for a state board or commission

Apply for a local board or commission

Please tell us about the boxes you checked. For which office are you running/applying?

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12. If you are CURRENTLY in elected office, please provide your title and jurisdiction:

State Level (e.g. legislature, statewide):

Local Level (e.g. county, city, town):

School or Community College District:

Other:

Year elected:

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13. If you were PREVIOUSLY in elected office, please provide your title and jurisdiction:

State Level (e.g. legislature, statewide):

Local Level (e.g. county, city, town):

School or Community College District:

Other:

Years served:

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14. Help us plan educational and professional development opportunities for Fellows.

Do you have an idea for a CivEx session you would like to plan/present with staff?

Yes! I'd love to share my idea for partnering on a future session.

No, not at this time

If yes, please tell us about your idea.

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15. Do you have an idea for a theme for the Annual Flinn-Brown Convention?

Yes

Please share your ideas here and please indicate if you would be interested in participating in the planning committee.

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16. We'd like to find you on social media. Please share your:

LinkedIn profile (full URL)

X (Twitter) handle

Instagram

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* 1. We are making every effort to ensure your records are complete and up to date. For this section, please use your HOME address. (Required.)

Question Title

* 2. For this section, please provide your MAILING address if it is different from your home address - for example if you use a PO Box to receive mail, enter that here:

Question Title

* 3. We would love to know your birthday!

Question Title

* 4. What is your race/ethnicity (select all that apply)

Question Title

* 5. Please tell us if you have any past or current military affiliation, including branch and years of service.

Question Title

* 6. What is your voter party registration?This information is for demographic purposes only. We strive for the Fellowship to reflect Arizona, including political party affiliation statistics, and would like to gather the data necessary to help us measure this accurately.

Question Title

* 7. Tell us about your current place of employment: (Required.)

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* 8. Tell us about your professional field of work (Choose 1): (Required.)

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* 9. Tell us about your areas of professional expertise (Choose 3): (Required.)

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* 10. What has been new in your professional or civic leadership activities this year? (Check all that apply.)

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* 11. Are you planning on any of the following in the next year?

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* 12. If you are CURRENTLY in elected office, please provide your title and jurisdiction:

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* 13. If you were PREVIOUSLY in elected office, please provide your title and jurisdiction:

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* 14. Help us plan educational and professional development opportunities for Fellows. Do you have an idea for a CivEx session you would like to plan/present with staff?

Question Title

* 15. Do you have an idea for a theme for the Annual Flinn-Brown Convention?

Question Title

* 16. We'd like to find you on social media. Please share your:

1. We are making every effort to ensure your records are complete and up to date. For this section, please use your HOME address. (Required.)

2. For this section, please provide your MAILING address if it is different from your home address - for example if you use a PO Box to receive mail, enter that here:

3. We would love to know your birthday!

4. What is your race/ethnicity (select all that apply)

5. Please tell us if you have any past or current military affiliation, including branch and years of service.

6. What is your voter party registration?

This information is for demographic purposes only. We strive for the Fellowship to reflect Arizona, including political party affiliation statistics, and would like to gather the data necessary to help us measure this accurately.

7. Tell us about your current place of employment: (Required.)

8. Tell us about your professional field of work (Choose 1): (Required.)

9. Tell us about your areas of professional expertise (Choose 3): (Required.)

10. What has been new in your professional or civic leadership activities this year? (Check all that apply.)

11. Are you planning on any of the following in the next year?

12. If you are CURRENTLY in elected office, please provide your title and jurisdiction:

13. If you were PREVIOUSLY in elected office, please provide your title and jurisdiction:

14. Help us plan educational and professional development opportunities for Fellows.

Do you have an idea for a CivEx session you would like to plan/present with staff?

15. Do you have an idea for a theme for the Annual Flinn-Brown Convention?

16. We'd like to find you on social media. Please share your: