Certificate Form

By Firstname Lastname,
Title
Organization

Subhead – Heading 3

Certificate in Public Affairs Management Application

Name(Required)

First Last

Date(Required)

Email(Required)

Organization(Required)

Title(Required)

Years of experience(Required)

To apply for the program, individuals must have a minimum of 7 years of experience during which the individual demonstrated responsibilities for function management, cross-functional leadership and/or strategy-level decision-making for public affairs.

Please enter a number from 7 to 80.

Name of person to whom you report

First Last

Title of person to whom you report

Would you like us to keep your supervisor updated with your progress?

Yes

Please list your relevant previous job experience(Required)

Organization

Title

Dates of Employment

Did you supervise employees?

Please provide a comprehensive overview of your current responsibilities.(Required)

What are your areas of expertise?(Required)

What are you hoping to achieve in pursuing this certificate?(Required)

Resume

If you would like to attach your resume or other supporting documents, you can do so here (not required).

Drop files here or

Accepted file types: pdf, Max. file size: 64 MB, Max. files: 3.

Questions

Staff Name
Manager of Something or Other
xxx.xxx.xxxx | email

Government Relations & Policy Conference

Enhance your government relations strategy, build your community.

Certificate Form

Certificate Form

Subhead – Heading 3

Certificate in Public Affairs Management Application

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