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ALF Nomination Form for
Fellows Program

The American Leadership Forum is comprised of individuals who:

  • Have demonstrated a capacity for leadership in their chosen fields
  • Exhibit interest and concern for the future of the community and the state
  • Reflect Oregon's diversity (racial, ethnic, geographic, occupational, political, etc.)

For assistance or questions, please contact the American Leadership Forum of Oregon at (503) 636-2288 or info@alfo.org.

 

Date of Nomination Submission
Name of nominee
Is Nominee aware of his/her nomination?
Gender
Title
Company/organization
Address
Telephone
Email
Please comment on the extent to which the nominee sees his/her future in Oregon
Please list affiliations of nominee (board/commission/council/association/committee/task-force/membership/etc. - Indicate "C" for current and "P" for past
Please list up to five (5) reasons why the nominee would be a valuable addition to the ALF network and mission (include nominee's public service interests, etc.):

Please complete the following categories:  Race/Ethnicity, Political Affiliation, Sexual Orientation, Religious Observation, Other -- with words that you feel best describe the nominee.

Race/Ethnicity
Political Affiliation
Sexual Orientation
Religious Observance
Other aspects of diversity nominee might contribute to an ALF class:
What are the nominee's likely sources of funding for the ALF Fellows Program Tuition?
Nominator's Name
Relationship to ALF:
Organization & Title
Organization Address (Street, City, Zip):
Work Phone:
E-mail Address:
Please list other ALF Senior Fellows who also know and might be able to comment on this nominee (if applicable):

Before submitting this form, please click on the link below to move the contents of box "A" into box "B" leaving the first box empty.

A: B: Click to Move


 

Any decision to offer membership in the class will be communicated to the nominator (by e-mail) before it is communicated to the nominee.

American Leadership Forum of Oregon

221 NW Second Ave., Suite 306, Portland, OR 97209

503-636-2288 TEL • 503-220-1335 FAX

American Leadership Forum - Oregon
Copyright © 2012 American Leadership Forum - Oregon
Address: 221 NW Second Avenue, Suite 306 • Portland • Oregon • 97209 • Tel: (503) 636-2288 Fax: (503) 220-1335 | Email: info@alfo.org

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