Flinn-Brown Fellows Directory Update Survey

With 465 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.

Name *

Home Address *

Home Address 2

City/Town *

State/Province *

ZIP/Postal Code *

Country

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. Tell us more about your educational background:

Undergraduate college or university:

Undergraduate degree and field:

Year:

Graduate/professional college or university:

Graduate/professional degree:

Year:

Other:

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* 6. Tell us about your current place of employment:

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

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

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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* 9. 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

Received a new job or promotion in state government

Received a new job or promotion in local government

Received a new job or promotion in private sector

Received a new job or promotion in a non-profit organization

Not applicable - no changes to report

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

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* 10. 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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* 11. 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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* 12. Are you planning on any of the following in the next year?

Run for state level elected office

Run for local level elected office

Pursue a career in state government / university

Pursue a career in local government

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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* 13. What is your political affiliation:

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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)

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.

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!

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

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* 5. Tell us more about your educational background:

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* 6. Tell us about your current place of employment:

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

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

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

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

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

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

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* 13. What is your political affiliation:

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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:

* 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?