N.C. State University Black Alumni Society

Executive Board Application

1. Name

2. Which position are you applying for?

3. Have you ever been a member of the Black Alumni Society executive board?

Yes
No

4. Why do you want to become a member of the executive board? What do you plan to accomplish in your position if appointed?

5. Year(s) of graduation or enrollment at NCSU

6. Please list all degrees you have received

7. Phone Number

Work Home Other

8. Email address

9. Please list any post-graduation extra-curricular activities

10. Please list any NCSU activities you are/were involved in (optional)

11. Current BAS board member reference(s) (optional)

12. How did you find out about the Black Alumni Society?

13. Additional information