FBLA State Officer Application by jolinmilioncherie

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									    Georgia FBLA State Officer Application (2012-2013)
Name:                                                  Adviser:
School:                                                School System:
Two (2) sets of a completed application packet must be received by February 15, 2012. Mail to: Georgia
FBLA, State Officer Application, 3316-A South Cobb Drive, Suite #229, Smyrna, GA 30080 (it is
recommended that you send using some tracking method). You should retain a copy of your entire
signed application for your records. A completed application set consists of the following items
completed in full:
   Application Form: Georgia FBLA Area:
   Appendix A: Duties of FBLA State Officers (signed by candidate, adviser, and parent)
   Appendix B: Duties of FBLA State Officer Adviser (signed by candidate and adviser)
   Appendix C: School Certification Form (signed by adviser, candidate’s parent, school CTAE supervisor, school
                    principal, system CTAE director, and school system superintendent/designee)
   Appendix D: Medical Release Form (include copy of health insurance card)
   Appendix E: Adviser Assurance Form (signed by adviser)
   Appendix F: Officer Uniform Sizes Form
   Appendix G: Officer Travel Permission Form
Each essay should be no more than 300 words and must follow the FBLA Format Guide format for a left-bound report.
   Essay 1: Explain why you want to be a Georgia FBLA State Officer and what you hope to receive from this
              experience. Include a description of why you decided to run for state office.
   Essay 2: Explain what you feel the state officer experience is all about.
   Essay 3: Explain how the FBLA activities in which you have participated have increased your qualifications to serve
              as a Georgia FBLA state officer.
   Essay 4: Describe the role you have played in your local chapter’s membership recruitment efforts and how that will
              assist you to drive the state chapter’s membership recruitment efforts.
   Essay 5: Explain how the state officers can and should assist local chapters in their development.
   Resume of candidate not to exceed two (2) pages which lists qualifications for office and involvement on the
   local, state, and national levels
   Statement of proposed platform for office not to exceed three (3) pages
   Letter of recommendation for candidate from CTAE Director or Supervisor (administrator level)
   Letter of recommendation for candidate from head of business department
   Letter of recommendation for candidate from adviser who will serve as primary state officer adviser
   Letter of recommendation for candidate from community or business leader on applicant’s character
   Letter of recommendation for candidate from another individual (optional)
   Copy of candidate’s high school transcript (including Fall 2011 grades)
   Letter from school administrator concerning candidate’s absenteeism and tardiness
   Picture of Candidate in Professional Business Attire (full color picture of candidate in official dress should be
    scanned onto a 8.5” x 11” sheet of paper – image should be no larger than 4” x 6”)
   Business Achievement Award Level Verification:
    BAA Certification from national office or copy of completed application for required level(s)

The application should be submitted in the order in which they appear above. You must submit two (2) copies of
each set of the above items. Both sets should be placed in a single 1 inch white, three-ring presentation/view
binder, with a divider page separating the two copies of the application. Do not place pages in sheet protectors.
You must include a CD that contains a copy of this application (completed but without signatures) and all essays,
platform, resume saved in Microsoft Word. The CD should be labeled with candidate’s name and school.

                 This page must be inserted in the front cover display on the presentation binder.
               FBLA State Officer Application – 2012-2013
Name of Candidate:                                             School:

Members wishing to apply for state office must complete this application and get it certified by principal and county superintendent.
APPLICATION MUST BE RECEIVED BY FEBRUARY 15, 2012. Faxed or e-mailed copies will NOT be accepted.

Please fill out the items below completely. Applications should be typed and printed. NOT HANDWRITTEN!

I.       Personal Information
         A.    Applicant’s Full Name:
         B.    If officer goes by another name, list that here:
         C.    Date of Birth:
         D.    Home Mailing Address:
               Home City, State, Zip:
         E.    Home Phone:
         F.    Personal Email Address:
         G.    Number of years as a high school FBLA member (including this year):
         H.    Grade during 2011-2012 School Term:                 Sophomore          Junior
         I.    FBLA Offices held and term of office:


         J.    Business & Computer Science courses completed or currently enrolled in:



II.      Chapter Information
         A. School Name:
         B. Chapter #:
         C. School Address:
              City, State, Zip:
         D. School Phone:
         E. School Fax:
Name of Candidate:                                      School:


III.    Adviser(s) Information (List only those advisers who will serve as state officer
        advisers)
        A. Primary Adviser’s Name: (prefer having same adviser travel with officer at all times)


        B. Adviser’s Home Address:
            City, State, ZIP:
        C. Adviser’s Home Phone
        D. Adviser’s School E-mail:
        E. Adviser’s Home E-mail:


        Additional Advisers who may also be traveling with state officer:
        A. Adviser’s Name:
        B. Adviser’s Home Address:
            City, State, ZIP:
        C. Adviser’s Home Phone:
        D. Adviser’s School E-mail:
        E. Adviser’s Home E-mail:


        A. Adviser’s Name:
        B. Adviser’s Home Address:
            City, State, ZIP:
        C. Adviser’s Home Phone:
        D. Adviser’s School E-mail:
        E. Adviser’s Home E-mail:
Name of Candidate:                                       School:


IV.     Candidate FBLA Participation
Please check the box for the conferences that the candidate was registered for and attended:
Note: Only those conferences where you attended as an official FBLA or ML member count. Conferences attended as a
guest (i.e., if your family members attended and you went along) do not count toward qualification.
School Year               SLOTS       Rally        FLC       NFLC          RLC          SLC          NLC
2011-2012                                                                                n/a          n/a
2010-2011                                                                                           (Orlando)
2009-2010                                                                                           (Nashville)
2008-2009                                                                                           (Anaheim)
2007-2008                                                                                           (Atlanta)
2006-2007                                                                                           (Chicago)
2005-2006                   n/a                                                                     (Nashville)

Please list all FBLA competitive events in which you have competed and specify the place you received, if applicable (list
only those places in which you were recognized during the awards program). Only list official FBLA competitive events
(refer to the Chapter Planning Guide or Competitive Event Guidelines for a list of official competitive events). If you
competed at RLC, SLC, and/or NLC in the same event, please list these on separate rows. Note: competing placing in
team open testing events at Rally or FLC does not qualify.

Name of Event (one event per row)                  RLC/SLC/NLC* Year               Place Received




* For Battle of the Chapters, list SLC.
                                                             *APPENDIX A*
                               DUTIES OF FBLA STATE OFFICERS
Name of Candidate:                                                              School:

The State Officer shall:
        A. Attend all FBLA meetings, workshops, and conferences on the local, regional, and state levels;
        B. Serve as a delegate at the National Leadership Conference;
        C. Submit all assignments by the stated deadline;
        D. Promote Georgia FBLA through the visitation of schools, businesses, etc.;
        E. Wear official dress when requested by State Adviser;
        F. Assume responsibility for implementing the Program of Work
        G. Make arrangements for transportation to all events;
        H. Represent the State Chapter at functions such as Georgia Association for Career & Technology Education, and other
            various functions;
        I. Maintain an up-to-date mailing list of every chapter in area;
        J. Recruit members for local chapter;
        K. Assist in state membership recruitment efforts and campaigns;
        L. Attend:

The following activities are REQUIRED of all state officers for 2012-2013:
         1. State Officer Training & Planning Meeting– TBD ................................................................. April 19-22, 2012
         2. CTSO State Officer Training –FFA-FCCLA Center ................................................................... June 7-10, 2012
         3. Institute for Leaders – San Antonio, Texas ............................................................................... June 27-29, 2012
         4. National Leadership Conference – San Antonio, Texas ...................................................... June 29-July 3, 2012
         5. Summer Leadership & Officer Training Summit (only need to attend one day) .......................... July 9-12, 2012
         6. Region Officer Academy – FFA-FCCLA Center ....................................................................... July 13-14, 2012
         7. GACTE Summer Conference ..................................................................................................... July 15-18, 2012
         8. Fall Motivational Rally – Perry ............................................................................................October 10-11, 2012
         9. Fall Leadership Conference – Athens...............................................................................November 13-15, 2012
         10. Winter CTSO State Officer Training –FFA-FCCLA Center ........................................................... January 2013
         11. Region Leadership Conference ....................................................................................................... January 2013
         12. CTSO Legislative Luncheon/Day at the Capitol ........................................................................... February 2013
         13. Middle Level State Leadership Conference/State Officer Qualifying – Macon .......February 28-March 2, 2013
         14. FBLA State Leadership Conference – Atlanta ...................................................................... March 14-17, 2013

The following activity is REQUIRED of the State President and STRONGLY ENCOURAGED for all state officers for 2012-
2013 (the actual conference will be determined in April at State Officer Training):
         15. National Fall Leadership Conference – Denver, Colorado .......................................... November 9-10, 2012 OR
             National Fall Leadership Conference – Charlotte, North Carolina ..................................November 16-17, 2012

The following activities are REQUIRED of the State President for 2012-2013:
         16. PBL State Conference – Atlanta** ........................................................................................... April 13-14, 2012
         17. CTSO Legislative Breakfast Rehearsal ...................................................................... (Saturday) February 2013

I understand that failure to comply with the officer responsibilities listed above will result in termination of office by the Board of
Directors. I understand that I must attend all required functions above and will not receive permission to miss any of these meetings.
Should I leave office prior to the completion of my term, I agree to reimburse Georgia FBLA for the costs associated with the
purchase of my uniform. I will assist at all of the Georgia FBLA conferences and the executive council meetings in any manner
requested by the state adviser.

                                                                    Signatures:
                                                                                           Adviser(s)

                                                                                           Candidate

                                                                                           Parent

                                                                                              Date
                                                    *APPENDIX B*
            DUTIES OF FBLA STATE OFFICER ADVISERS
Name of Candidate:                                            School:

The Adviser shall:
       A. Attend all Executive Council Meetings and other business meetings of the State with the officer;
       B. Attend all FBLA meetings, workshops, and conferences on the local, regional, and state levels;
       C. Assist the officer in carrying out his/her duties;
       D. Assist in the Fall Motivational Rally, Fall Leadership Conference, Region Leadership Conference, Middle Level State
            Leadership Conference, and State Leadership Conference;
       E. Provide or arrange transportation for the officer from his/her school;
       F. Have access to email at home and school;
       G. Apply for extended day pay, if desired and eligible;


Given the nature of being a state officer adviser and the training that is provided at each meeting, it is STRONGLY
RECOMMENDED that the same local chapter adviser travel with the student to all Executive Council meetings.


                                                     Signatures:
                                                                        Adviser(s)

                                                                        Candidate

                                                                        Date
                                                 *APPENDIX C*
                                       SCHOOL CERTIFICATION FORM
Name of Candidate:                                              School:

Date:

To:               Monty Rhodes, Georgia FBLA Executive Director

From:                    , Superintendent or Designee

                         , System CTAE Director (if applicable)

                         , Principal

                         , School CTAE Supervisor (Administrator level, if applicable)

                         , Adviser(s)

                         , Parent(s)

                         , School



The credentials for         , who is the choice of our chapter, are attached. To the best of our knowledge, this individual meets the
qualifications for Georgia FBLA state office and, if elected, will receive the enthusiastic support of the school, chapter, and the adviser
in execution of the duties of the office.

As administrator, I agree to provide travel money for the adviser(s) to carry out the tasks of the office for which the FBLA member is
a candidate.

Signed,



Superintendent or Designee                                                Principal




School System CTAE Director                                               Local School CTAE Supervisor




Adviser(s)                                                                Parent
                                      *APPENDIX D*
                                 MEDICAL RELEASE FORM
Name of Candidate:                                 School:

If my child is elected an FBLA State Officer, I understand that this honor requires him/her to attend a
variety of mandatory activities to represent his/her school and the State of Georgia. I will support my child
in all of these endeavors.


Likewise, for his/her protection, I hereby authorize my child’s local chapter adviser and/or the FBLA State
Adviser, to sign in my absence for any emergency medical treatment or hospitalization, to order injection,
anesthesia, or surgery that my child should need when he/she is attending FBLA activities this year.


I understand that my child’s local chapter adviser, state adviser, and Georgia FBLA, Inc., cannot be held
liable for any accident or injury that my child may incur while attending an FBLA activity this year.


Student Name:
Office:
School:


Special Medical Needs/Medications Taken




   PHOTO COPY MEDICAL CARD HERE: (FRONT AND BACK)




Name of Medical Insurance Company
Number of Policy/Contract/Insurance Card
                              *APPENDIX E*
                              Adviser Assurance Form
Name of Candidate:                      School:

I will ensure that my State Officer is supervised at all times. If I am unable to
chaperone my student, it is my responsibility to make the necessary arrangements
for another adviser to chaperone my student. I am responsible for the actions and
behavior of my State Officer. I understand that I am required to be at conferences
at all times that my officer is present.

I will ensure that my State Officer fulfills all of his/her duties, as defined by FBLA
guidelines and the leadership of the Georgia Future Business Leaders of America,
Inc. I will ensure that my student attends all mandatory events and is on time,
prepared academically, and in the appropriate business attire. I will also ensure that
my student completes all assignments in a timely fashion and at a high quality.

As an adviser to a State Officer, I understand I am expected to assist in workshops,
rallies, conferences, and competitions in a variety of duties which will be outlined
for me by FBLA guidelines and the leadership of the Georgia FBLA, Inc.



Signature of Adviser(s)


School Name


Officer Name
                                               *APPENDIX F*
                                              Officer Uniform Sizes Form
Name of Candidate:                                           School:

Gender:          Male          Female                        Height:

These measurements will be used to order your state officer uniform. Please ensure that measurements are complete,
correct, and accurate. You must get measured by a professional rather than relying on current sizes and measurements.

For Male Officers:
You must go to a tailor or men’s clothing shop to be measured. Do not rely on current measurements.
Dress Shirt:
Neck size (enter number):          (example – 15 ½)
Sleeve length (enter number):          (example – 34)
Polo Shirt:                                                    T-shirt Size:
Size (S, M, L, XL):                                            Size (S, M, L, XL):
Pants:
Waist Size (enter number):          (example – 34)
Inseam Size (enter number):           (example – 32)
Suit:
Jacket size (enter number & coat length):          (example – 38 Short or 40 Regular or 42 Long)
Shoes:
Shoe Size (enter number):          (example – 9 ½)



For Female Officers:                                    Check here if petite sizes are needed.
Dress Shirt:
Size (enter number):          (example – 7)
Polo Shirt:                                     T-shirt Size:                         Oxford Shirt Size:
Size (S, M, L, XL):                             Size (S, M, L, XL):                   Size (S, M, L, XL):
Pants:
Size (enter number):          (example – 8)
Suit:
Jacket size (enter number):         (example – 8)
Shoes:
Shoe Size (enter number):          (example – 9 ½)

Measurements:
As sizes often differ among manufacturers, please provide the following measurements to facilitate in get the correct size:
Bust              Waist:         Hips:


Adviser Polo Shirts: Georgia FBLA provides a complimentary polo shirt and a nametag for one adviser. If there are multiple
advisers, the others may purchase a state officer adviser polo shirt and nametag at a cost of $40 per adviser.

Name on shirt:                                          Male      Female Polo Shirt Size:          T-shirt Size:
Name on shirt:                                          Male      Female Polo Shirt Size:          T-shirt Size:
Name on shirt:                                          Male      Female Polo Shirt Size:          T-shirt Size:
                                             * APPENDIX G *
                                 Officer Chaperone/Travel Permission Form
Name of Candidate:                                              School:

It is necessary for student officers to travel with their advisers or an adult chaperone to/from required Georgia FBLA functions. Under
no circumstances will student officers be allowed to drive themselves or other officers to or from meetings, conferences, activities.
All FBLA officers must adhere to their local school’s student transportation and chaperone policies and procedures. Since the local
adviser serves as a chaperone for the student officer while the student travels on FBLA business, the adviser and/or designee must stay
at the same hotel property as the student on all overnight trips. In instances where a local school policy does not permit a student to
travel with a school employee, the parent/guardian must assume responsibility for transporting the student to/from required Georgia
FBLA functions. However, in these instances where a parent/guardian transports a student, the presence of the adviser is still
required.

Please attach a copy of the completed school documentation pertaining to student travel for school activities – or – complete the form
below.

  Initial any or all of the following that apply (Must be initialed by parent and school administrator):
  Parent              Administrator

  1a. ___________      __________      If approved by the parent/guardian and local school system, the above named student may be
                                       transported by his/her local adviser or other designee (school employee) to, during, and from
                                       functions as part of his/her official responsibilities.

  1b. __________      __________       If the above is not signed, I understand it is the adviser’s responsibility to arrange with the
                                       parents and school administrators acceptable transportation options so that the officer is able
                                       to perform his/her official responsibilities.

  2.   __________     __________       If approved by the parent/guardian and local school system, the above named student may be
                                       transported with adult representatives of Georgia FBLA, Inc., to, during, and from functions
                                       as part of his/her official responsibilities.




As a school official, my signature below verifies that the above checked modes of transportation comply with our student
transportation policy and/or exceptions have been made that will permit this student to attend required functions.




____________________________________________                    _____________________________________                   ______________
School Administrator                                            Title/Position                                          Date

My signature below indicates that I have read and understand the enclosed student transportation policy. In addition, I agree to adhere
to the above mode(s) of transportation.




____________________________________________                    _________________________
Parent/Guardian                                                 Date



____________________________________________                    _________________________
Student                                                         Date

								
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