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You are filling out this application because you are interested in being a Platinum Chapter Chair. Please fill in the application below.

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* 1. Full Name

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* 2. Preferred Pronouns

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* 3. Email

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* 4. Home City/State

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* 5. Current Chapter (If WPO or other Peer organization):

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* 6. How many years have you been a WPO Chapter Chair or facilitator in other organization?

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* 7. What are the three most important contributions you have made as a chair or facilitator?

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* 8. Why do you want to be the Chapter Chair of a Platinum Chapter and why would you be excellent at it?

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* 9. Do you have any certifications, training, or degrees you would like to note?

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* 10. Tell us about the relevant skills and technical abilities you have that apply to this position (see job description).

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* 11. Part of being a Platinum Chapter Chair is securing speakers and curating content. Do you have access to a network of high level speakers and if not, how do you plan on securing speakers at low cost?

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* 12. There are many logistics involved in being a Platinum chapter chair. Using the below scale, please indicate how comfortable and adept you are with the below:

  Extremely Comfortable and/or Adept Somewhat Comfortable and/or Adept Not Very Comfortable and/or Adept
Creating and distributing agendas and other administrative tasks
Handling onsite logistics (room set up. food questions, traveling to/from dinners, getting taxis/ubers)
Staying in touch with the chapter between meetings (through slack/conference calls/emails)
Coordinating with speakers and negotiating contract terms

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* 13. Rate your level of expertise in these areas:

  1- Novice 2 3- Proficient 4 5-Master
Promote Group Cohesion and Member Engagement
Contribute Strategic Growth and Leadership Practices
Foster Continuous Learning and Development
Plan, Manage and Facilitate Meetings

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* 14. Of the below qualities, I am especially good at (select all that apply):

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* 15. What is your start date availability (Month/Year)

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* 16. Anything else you would like us to know?

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* 17. By submitting this application, I acknowledge that, if selected, I will serve as an independent contractor. I am not an employee, agent or representative of the WPO and nothing in this application or subsequent agreement shall be construed to create an employment relationship.

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