Contact Information



|Contact Information |

|Committee members must be available to meet in Alexandria, VA, on Sunday, March 1, and Monday, March 2, 2020. |

|PRIMA will fund travel expenses for this meeting. |

|Name |      |

|Title |      |

|Entity |      |

|Membership Number |      |

|Address |      |

|City, State, Zip |      |

|Email Address |      |

|Phone |      |

|Fax |      |

|Qualifications |

|Have you been a PRIMA member for at least three consecutive years? Yes No |

|How many years of risk management experience do you have? |

|1-5 years 6-10 years 11-15 years 16-20 years 20 or more years |

|Have you served on the Leadership Development Committee before? Yes No |

|If so, when:       |

|Have you served on any of PRIMA’s Committees? Yes No |

|If so, when and which committee(s)? |

|      |

|What qualifies you to be on the Leadership Development Committee and why do you wish to serve PRIMA in this capacity? |

|      |

|Please list any other boards that you have served on in the past and/or any other leadership capacity that you have served. |

|      |

|Resume |

|Please attach a copy of your resume for review by PRIMA’s Board of Directors. |

| |

|Completed application and supporting materials may be sent via e-mail to jackerman@, or |

|by fax to 703-739-0200, Attn: Jennifer Ackerman, by September 9, 2019. |

Leadership Development Committee

2019-2020 Application

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