CSO email address (we need this in order to link to new alumni classroom)

First Name *

Last Name *

In which Region was your program hosted? *

What State/Country are you currently living or planning to live? *

If you live in another area please indicate below

What years were you in the CSO Program (check all that apply) *

What year did you graduate from high school? *

What are/will be your plans after graduation? *

If "Other" please indicate below

If you are continuing your education, please list the name of the school below

Please indicate the city and state of your school

If applicable, please list the name of your major

If you are not attending school or have finished school and are working please indicate your industry profession.

Are you interested in being a part of the CSO International Alumni Program? (Volunteering and/or Professional Development and Networking) *

I am interested in professional development. *

I am interested in networking. *

I am interested in volunteering *

I am interested in helping in the following ways (please check all that apply)

Please indicate "Other" below.

I am interested in being a part of the alumni leadership group? (The alumni leadership group will work in a variety of capacities to help form and guide the direction and planning of the CSO International Alumni Association) *

We are excited that you are interested in participating in the alumni leadership group. Please gather the following items and email them to Jake Lounsbury (Jake@chiefscienceofficers.org) by July 31st. 1.Recommendation from Regional Lead 2.Statement of interest. Please share with the group the following either in a video or written document a. why you are interested in being part of the leadership group b. what the CSO program meant to you during your time c.overview of action plan(s) you did during your time in the CSO program.

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