2023 NMSCPA Leadership Academy Application After completing this application, email Jeanette Contreras (Jeanette@nmscpa.org) your resume and a letter of recommendation from your current employer. We will confirm your submission as soon as we receive all the required documents. For questions and more information, contact Jeanette at 505-246-1699 or Jeanette@nmscpa.org. Question Title * 1. Are you applying for yourself or are you nominating another individual? I am applying for myself to attend the 2023 Leadership Academy I am nominating another individual to attend the 2023 Leadership Academy If you are nominating another individual please include your contact information here: Question Title * 2. Contact Information (Leadership Academy Candidate) Name (First MI Last) Firm Name Firm Address City State ZIP Email Address Mobile Phone Question Title * 3. Gender (Leadership Academy Candidate) Male Female Question Title * 4. Birthdate (Leadership Academy Candidate) Question Title * 5. Position/Title (Leadership Academy Candidate) Question Title * 6. CPA License (Leadership Academy Candidate) Date State Question Title * 7. Name of College/University (Leadership Academy Candidate) Question Title * 8. Honors, awards, and other achievements (Leadership Academy Candidate) Question Title * 9. Are you a NMSCPA member? (Leadership Academy Candidate) Yes No Question Title * 10. Are you an AICPA member? (Leadership Academy Candidate) Yes No Question Title * 11. Practice Areas (check all that apply) (Leadership Academy Candidate) Academia Business & Industry Consulting Government Public Accounting Small Firm (less than 10 employees) Medium Firm (10 to 24 employees) Large Firm (25 or more employees) Question Title * 12. Please explain why you want to participate or why you want to nominate this individual for the 2023 NMSCPA Leadership Academy (500 words or less) Question Title * 13. Check the box below to agree to the following statement:I will submit my resume and recommendation letter no later than April 7, 2023. I will submit the required materials before the deadline Question Title * 14. I understand that my Firm/Employer/or Myself are responsible for the expenses related to the NMSCPA Leadership Academy ($1,500) Yes No Done