"Board of Trustee/Vice President"
Board of Trustee/Vice President Nomination Form (Confidential) Deadline March 15th ASM Office Use Only: Member ID: Years Eligible: Nomination is for (Please select one of the following) (Please select...) 1. Nominee Prefix: Nominee Name (FN, MI, LN): (Please select...) 2. Nominee’s Business Title: 3. Nominee’s Company or Institution Affiliation: Business Name Business Street Address Business City, State, ZIP Country Business Phone Business Fax Business E-Mail Address 4. Nominee’s Chapter Affiliation(s): 5. Nominee Home Address/Phone/Fax/E-Mail) Home Address Home City, State, ZIP Country Home Phone Home Fax Home E-Mail Address 6. Nominee’s Employment History: List company, position, number of years in chronological order Company Position Years Page 1 of 6 ASM International Board of Trustee/Vice President Nomination Form (Confidential) 7. Nominee’s Academic Background (up to 200 words) List institution, course, year, and degree or certification achieved Institution Course of Study Degree/Certificate Received 8. Nominee’s ASM Service (up to 300 words) National and Chapter Offices, Committees, Councils, Technical divisions, Affiliate Societies, etc. Provide dates of service as well in chronological order beginning with the most recent. 9. Nominee’s Honors and Awards, ASM and others, as applicable (up to 200 words) 10. Nominee’s Participation in other Technical Societies (up to 200 words) 11. Nominee’s Community Activities (up to 200 words) 12. Nominee’s Fields of Experience, Specialization and Interest (up to 200 words) KNOWLEDGE OF THE FIELD OF MATERIALS • TECHNICAL KNOWLEDGE • NEW TRENDS: – INTERNATIONAL TRENDS – BROAD KNOWLEDGE OF MATERIALS (STRUCTURAL & FUNCTIONAL) How might the nominee contribute to the facilitation of Society events or to the national/international stature of the society because of their personal recognition or extensive Page 2 of 6 ASM International Board of Trustee/Vice President Nomination Form (Confidential) contacts? Do they have a broad understanding of trends in engineered materials and materials science? 13. Managerial and/or Business (up to 200 words) BUSINESS PERSPECTIVE • PRUDENT BUSINESS JUDEMENT • FINANCIAL UNDERSTANDING • BROAD LONG RANGE PERSPECTIVE Provide evidence that shows the nominee can contribute to the business analyses of ASM’s products and services. 14. Understanding and Support of Goals, Issues and Opportunities (Strategy) (up to 200 words) • ACTIVITIES AND OBJECTIVES OF SOCIETY • PROBLEMS AND ISSUES SOCIETY WILL FACE IN COMING YEARS • QUALIFIED TO SET POLICIES AND GUIDE DESTINY OF SOCIETY • SOCIETY EXPERIENCE • LOCAL, NATIONAL, INTERNATIONAL PERSPECTIVES Provide specific examples of the nominee’s experience or accomplishments that employ strategic concepts and understanding to move ASM ahead. 15. Knowledge of Information Technology (up to 200 words) KNOWLEDGE OF COMPUTER SYSTEMS, SOFTWARE AND APPLICATIONS RELATED TO MATERIALS INFORMATION FLOW AND USE. Is the nominee conversant with information technology trends in support of materials research and dissemination of technology? Do they have background in technology transfer systems, electronic publishing, internet activities, which may improve the competence of the Board? Page 3 of 6 ASM International Board of Trustee/Vice President Nomination Form (Confidential) 16. Professionally Active (up to 200 words) Indicate how the nominee is currently contributing to materials science and engineering and if they are likely to remain so through their term as trustee. 17. Human Relations Skills (up to 200 words) • DISPLAYS PERCEPTION, INITIATIVE AND JUDGMENT • REPRESENTS ENTIRE SOCIETY • ABILITY TO WORK WITH PEOPLE Provide examples of the nominee’s leadership and team building skills. 18. In your estimation, will the following endorse the nominee’s membership on the ASM Board of Trustees? Nominee’s Company: Please Select.... Nominee’s Family: Please Select.... 19. Letters of Reference Please list the names of up to five (5) references and direct them to the Support Form Those who have agreed to submit the Support Form: 1. Name: Email: 2. Name: Email: Page 4 of 6 ASM International Board of Trustee/Vice President Nomination Form (Confidential) 3. Name: Email: 4. Name: Email: 5. Name: Email: Please attach the following three items (20-22) for this nomination 20. Current Biography: No more than 3 pages with a list of the nominee’s most significant papers, patents, etc., focusing on the most current information (last five years). 21. Candidate Vision Summary Statement: Please have the nominee provide their input to the following questions in the form of a letter no more than two pages long. Please have them address and provide responses to questions a-c below in their letter/summary statement. a. W HAT PRIORITIES WILL YOU HAVE IF ELECTED AS VICE PRESIDENT/OR TRUSTEE? b. W HAT PRODUCTS AND SERVICES SHOULD ASM FOCUS ON DELIVERING IN THE FUTURE TO BETTER SERVE ITS MEMBERS WITH INCREASED EFFICIENCY? c. W HAT WILL MAKE YOU AN EFFECTIVE VICE PRESIDENT / TRUSTEE? 22. Please include a recent photograph Page 5 of 6 ASM International Board of Trustee/Vice President Nomination Form (Confidential) Nominator Page This nomination is submitted by: Email Address: Phone: On behalf of: Member or Organization Member or Organization Name ASM Member Chapter Committee/Council Affiliate Society 23. Nominator Summary Statement (prepared and submitted by the nominator) Please provide a summary statement addressing how and why your nominee will be an effective Vice President/or Trustee? Nominator Signature Name (printed) *Signature (required) Date *Please note that electronic signatures are accepted. By typing in your name in the signature required box you are authorizing submission of this nomination. There is no need to paste a signature file. Thank you for submitting this candidate for consideration by the ASM Nominating Committee. You will be notified of the results of the Nominating Committee upon completion of the meeting and acceptance by those candidates who were selected for nomination. Return this form by March 15th to: Chairman, ASM Nominating Committee Staff Contact: 9639 Kinsman Road Leslie M. Taylor, Manager, Executive Office Materials Park, OH 44073-0002 U.S.A. email@example.com 440-338-5151 ext. 5500 Fax: 440-338-6614 To SUBMIT this form electronically please do the following - Select File from the menu bar - Select Send to Mail Recipient (as Attachment) Document3 Page 6 of 6