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.
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Date of Nomination Submission
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Name of nominee | |
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Is Nominee aware of his/her nomination?
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Gender
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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.): |
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Please complete the following categories: Race/Ethnicity, Political Affiliation, Sexual Orientation, Religious Observation, Other -- with words that you feel best describe the nominee.
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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): |
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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
PO BOX 521 • Marylhurst, Oregon 97036
503-636-2288 TEL • 503-636-2293 FAX |
