MESA Board Nomination Form - MESA International Inc

MESA Board Nomination Form

Board members are charged with furthering MESA's Mission while actively participating in board, committee and regional activities. A formal commitment is expected for regular participation and input as outlined in the Board Member Role Responsibilities documents. If you are interested in becoming a candidate, please fill out the form below. MESA's Leadership Development Committee will review and confirm all nominations.

Fields marked with an * are required.

First Name *

Last Name *

Job Title *

Organization *

Address Line 1 *

Address Line 2

City *

State *

Postal Code *

Country *

Phone *

Email *

Brief One-Paragraph Biography (will appear on ballot if accepted) *

Please attach a headshot photo *

20MB max

Which Board(s) are you applying for? *

You must reside in the region to be eligible for a regional board.

International

Americas

APAC (Asia-Pacific)

EMEA (Europe/Middle East/Africa)

Are you interested in an officer position? *

Chair, Vice Chair, Treasurer.

Are you interested in a Committee Chair position?

Describe why you should be considered to become a candidate for the board *

Describe the special skill sets you can bring to the board *

Describe the benefit you expect to receive as a board member *

Describe what you feel are the most significant challenges facing industry *

Describe your ability to engage your company and extended ecosystem in the MESA community. *

Attestation *

I am already a MESA Premium member or am willing to join if selected as Director. I will maintain my membership for the duration of the Board term.

I have flexibility in my work environment to participate, as well as have the financial support from my employer to be able to fulfill my responsibilities if selected as a Director.

I understand that I must attend 75% of the Board meetings annually in order to maintain eligibility to remain on the Board. This may require travel to a face-to-face meeting at least once a year (in non-pandemic times).

I have read and agree to fulfill the duties as outlined in the Board Member Role Responsibilities documents

I have read and agree to abide by MESA's Code of Ethics and Conduct. Read here: https://growthzonesitesprod.azureedge.net/wp-content/uploads/sites/2220/2021/05/MESACodeofEthicsandConduct-approved2014-07-29.pdf

I have read and agree to MESA's Conflict of Interest Policy. (You will be asked to complete this and submit it once your nomination is accepted). Policy here: https://growthzonesitesprod.azureedge.net/wp-content/uploads/sites/2220/2021/05/MESAConflictofInterestPolicy-approved2014-07-29.pdf

I have read and agree to the statements above.

Please verify that you have checked the “I'm not a robot” checkbox.