Bennion Center Committee Interest Form - Bennion Center

Contact Information

First Name

Last Name

Preferred Email

Mobile Phone

Office Phone

Home Phone

Address 1

Address 2

City

State

Zip/Postal Code

Educational Information

Undergraduate Institution

Undergraduate Graduation Year

(yyyy)

Undergraduate Degree

Graduate Institution

Graduate Graduation Year

(yyyy)

Graduate Degree

Employment Information

Current Employer

Title

Industry

In 250 words or less, how can you contribute as a Bennion Center Advisory Board Committee member?

(250 words max.)

Please list any current (or previous) volunteer board positions and dates of service.

Upload a current resume.

Files must be less than 2MB and have one of the following file extensions: doc, docx, rtf, txt, pdf.

Upload a short biography.

Files must be less than 2MB and have one of the following file extensions: doc, docx, rtf, txt, pdf.

Which committee(s) are you interested in? See descriptions below.

Nominated or recommended by

Questions? Contact Debbie Hair | 801-585-3296 | debbie.hair@utah.edu