MIAAA Admin Asst of the Year APPLICATION
In addition to submitting this form, each applicant must submit two or three letters of recommendation and a current professional photo in jpeg format to Awards Committee Chairperson, Carl Arkema at cwarkdog457@gmail.com
The photos needs to be at least 2 x 3, portrait style; they need to be at least 300 dpi and sent as a jpeg format. They should be relatively formal photos as well.
Email address *
Name (as it should be printed on the award) *
Your answer
MIAAA Region # *
Home Street Address *
Your answer
Home City, Zip *
Your answer
NIAAA Professional Designation *
School *
Your answer
School Street Address *
Your answer
School City, Zip *
Your answer
Work Phone Number *
Your answer
Cell Phone Number *
Your answer
Number of years I have served in the capacity of Administrative Assistant? *
Your answer
Number of years I have been registered and current MIAAA member? *
Your answer
Brief Career Summary *
Give a Brief summary including positions, locations & length of service.
Your answer
Educational Background *
High School and College (Undergraduate & Graduate)
Your answer
Professional Affiliations & Activities *
(Ex: membership in professional organizations, offices held, etc.)
Your answer
Significant achievements in the field of your profession and also contributions to local, state & national organizations *
Your answer
Honors & Awards Received
Your answer
Services to the Community
Your answer
Any personal information you may wish to include
Your answer
Name, Title, and address of immediate supervisor
Your answer
Media Release Information
Provide Name, phone, and email for the local media that should receive the press release if you are selected for the award.
Your answer
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