Survey | Qualtrics Survey Software

Please enter your contact information:

Name
Nickname (if any)
Mailing address
City/ State/ Zip Code
Country
Telephone
Cell Phone
E-mail
Fax
Company or companies you represented while belonging to a council
Job Title (at last full-time position)
Council(s) in which you participated

The Council Alumni Program is designed for retirees!

I confirm that I am not a full-time employee of a company or organization eligible for regular Associate membership in The Conference Board.

Would you be interested in working with The Conference Board on part-time special projects or consider being a program director for such things as councils, conferences, research working groups, or Webcasts?

Yes, please keep me in mind as opportunities arise	No, thank you

Please share any topics that would be of greatest interest to you going forward:
Other Comments or Questions:

(Optional) Please feel free to share your bio by pasting it in the space below or by emailing it to debra.wada@conference-board.org . A photo may also be sent to Debra if you'd like one included in your profile.

Upon receipt of your application an invoice for the annual participation fee of US$150 will be sent to you via e-mail and mailed as a hard copy.