Nominated Applicants (OLD)

Blue Ridge Nominated Member Application

In order to be considered for acceptance, all applications must be complete. Please be sure all the following elements are included in your application packet.

Completed Application Checklist

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The name of the BRI Leader who officially nominated you.

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Completed Application including essay responses

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Professional Photograph (forward .jpg or .png file below in the separate form provided)

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Copy of current resume, and/or vitae

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PLEASE NOTE: No payment is due when your application is submitted. If you are accepted, payment for conference fees will be collected at conference registration.

Blue Ridge Institute Nominated Member Application

Basic Information

Name*
Are you an Executive Leader in a community service organization?*
BRI defines executive leaders as the CEO/Executive Director (or equivalent position) or a senior leadership position that reports to the CEO/Executive Director of an organization/

Contact Information

Home Address*
Work Address*

Getting to Know You Better

Directions: Please answer the following questions. Please attempt to limit your responses to 250 words or less per essay.

Required Documentation

Directions: Please answer the following questions. Please attempt to limit your responses to 250 words or less per essay.
Please attach a photo for your profile in a .JPEG or .PNG format. Thank You!
Accepted file types: jpg, png, Max. file size: 2 MB.
Please attach a current resume or curriculum vitae.
Max. file size: 2 MB.

BRI Membership Profile

Directions: Please answer the following questions. Please attempt to limit your responses to 250 words or less per essay.