EmailMe Form - SC&RA's 4 Under 40 Application

Applicant Name *

First Last

(Exactly how you want it published in print/online)

Birthday *

MM / DD / YYYY

SC&RA Member Company *

Applicant Must be a Full Time Employee of a Current SC&RA Member Company

Title *

Office Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Office Phone Number *

### - ### - ####

Cell Phone Number *

### - ### - ####

Email *

Website *

Education: For all certifications, training, undergraduate, and graduate degrees, include the institution, degree, year graduated and major. *

Provide at least one example of how you have contributed to your current company or organization's growth, innovation, or profitability over the past 12 months. *

Provide at least one example of how SC&RA's benefits, services, and/or industry representation efforts have impacted your professional growth over the past 12 months. *

What is the biggest challenge that you've had to overcome thus far in your professional career and how did you overcome that challenge? What was the end result and what did you learn as a result? *

Please list any community or civic organizations that you currently belong to. Include your position (member, treasurer, board director, etc.), and how you've specifically helped the mission. *

List out the three things you are most proud of so far in your professional career (and give details). *

(Note: We're looking for examples of when your own efforts, or the decisions you made positively impacted you professionally. This is your chance to wow the selection committee! "Working with a great team," or "finding a work-life balance," will not be considered unique, individual achievements by the selection committee.)

Share a reference letter from a supervisor, client, or colleague on why selection committee & SC&RA should consider you for selection as part of the 2024 4 Under 40 class. *

Up to three reference letters are allowed, and you can upload them below.

Please Sign this box to release any of the information provided in this application (or testimonials) for SC&RA and AC&T editorial use in a brief profile that would highlight some of your career accomplishments, if you are chosen as one of the 4 selections for the 2024 class.

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By signing this box, you also are signing off that any compliance department (if applicable for your company) has approved that all of the information included above can be used by the SC&RA and AC&T team in an editorial profile. If you do not sign this box before submitting your application, it may hinder your chances of making the final selection.

Signature *

First Last