Who's Who in America's Credit Unions : Online Biographical Submission Form

Online Biographical Submission Form Download Biographical Submission Form (PDF)

Biographical Submission Form

Please note, this online form has limited character space allotment. If additional space is needed, please download and print the form from the printable format link above. The completed form may be mailed to: Who's Who in America's Credit Unions, 5511 Highway 280, Suite 224, Birmingham, AL 35242 or Fax to 205-991-2937.
NAME Mr. Mrs. Ms. Dr. Other
LAST: FIRST: MIDDLE: ADDRESS (For Publication: Yes No ) STREET: CITY: STATE: ZIP: (The following three categories are not for publication.) TELEPHONE: FAX: E-MAIL:
DATE OF BIRTH: (For Publication: Yes No ) / / OCCUPATION: SPOUSE'S NAME:
EDUCATION
Degree Earned	School or University
City and State	Years Attended

Degree Earned	School or University
City and State	Years Attended

Degree Earned	School or University
City and State	Years Attended

CAREER INFORMATION
Position Held	Employer
City and State	Years Employed

Position Held	Employer
City and State	Years Employed

Position Held	Employer
City and State	Years Employed

CREDIT UNION RELATED ACTIVITIES
Activity	Organization
City and State	Years Involved

Activity	Organization
City and State	Years Involved

Activity	Organization
City and State	Years Involved
CREDIT UNION DESIGNATIONS & CERTIFICATIONS
Designation or Certification	Organization
Year Received

Designation or Certification	Organization
Year Received

Designation or Certification	Organization
Year Received
CIVIC, COMMUNITY & RELIGIOUS ACTIVITIES
Activity	Organization
City and State	Years Involved

Activity	Organization
City and State	Year Involved

Activity	Organization
City and State	Year Involved
HONORS, RECOGNITIONS & AWARDS
Award	Granting Organization
Year Received

Award	Granting Organization
Year Received

Award	Granting Organization
Year Received
CREDIT UNION MEMBERSHIPS & AFFILIATIONS
Organization	City and State
Year Affiliated

Organization	City and State
Year Affiliated

Organization	City and State
Year Affiliated
OTHER PROFESSIONAL MEMBERSHIPS & AFFILIATIONS
Organization	City and State
Year Affiliated

Organization	City and State
Year Affiliated

Organization	City and State
Year Affiliated

MILITARY RECORD
Highest Rank	Branch of Service
Years Served

Highest Rank	Branch of Service
Years Served

Additional Comments:
Terms and Conditions Who’s Who in America’s Credit Unions, LLC (WWACU) reserves the right to select appropriate material for publication consistent with space limitations, style and standards as determined by WWACU. In the event of errors in the publication, the sole responsibility of WWACU will be to correct such errors in a succeeding edition of the publication and will be in lieu of any other remedy. WWACU expressly disclaims all other liability for loss or incidental damage or consequential damage whether arising from negligence, contract, or other cause to any party for errors in publishing. Submission of this form by the named individual constitutes permission for WWACU to contact you and to publish the information in print, electronic database, or other form and distribute such information for publication and use by other parties. No purchase is required to be included in an annual edition of Who’s Who in America’s Credit Unions. I agree to the terms

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