Movers and Shakers 2020 Application
Personal Information
This information is kept private, and will not affect your application in any way. Applications are scored double-blind by a team of judges.
First Name *
Your answer
Last Name *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Address *
Include city, state, and zip
Your answer
Phone Number *
Your answer
Email Address *
Your answer
Job Title *
Your answer
Employer *
Your answer
Biographic Summary *
This will be used in the ceremony's program with minimal editing if you are selected for an award. (500 character limit, please write in 3rd person)
Your answer
Application
Please use first-person speech
Detailed Questions
2500 character limit per question. Please respond using first person.
List the social, philanthropic and/or professional organizations or activities that you have been ACTIVELY involved in within the last 2 years? Please include any leadership positions you have held as part of these organizations/activities. *
Your answer
List any awards you have received over the past 5 years. *
Your answer
What has been your greatest accomplishment to date and what obstacles did you overcome to achieve this accomplishment? *
Your answer
Discuss one (1) example in which you have displayed strong/effective leadership and/or have made a positive impact on your community. *
Your answer
Photo Submission
Use the Box.com submission form below to submit a professional headshot. This will be used in the program during the 2020 Movers and Shaker's if you are selected.
Submit
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This form was created inside of Cleveland Professional 20/30 Club.