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40 Under 40 Survey

Please fill out the following survey to be considered for In Business magazine's 40 Under 40, an annual feature showcasing 40 influential, emerging leaders under the age of 40.

Note: Submission deadline to be considered for the next class is December 1.

* indicates required field
Full Name*
Title*
Company*
Company Address*
City*
State*
Zip Code*
Phone Number*
E-mail Address*
Web Site
Company Description (8 words or less)*
Position Description*

Personal Data

Date of Birth and Birthplace*
Spouse/Partner Name

Education

Undergrad: College, Year Graduated, Degree
Graduate and Post-Grad: College, Year Graduated, Degree

Current Business Board of Director Memberships

Company, Title (Limit 3)

Current Professional & Civic Organizations

Organization, Title (Limit 3)

Additional Questions (Please provide approximately 5 sentences for each response.)

What is your proudest career achievement and why?*
Who in the Greater Madison business community do you identify as a good leader, or someone you would like to emulate in your career, and why?*
What are your career aspirations?*
What is the one thing you would like to see changed to make Madison a better place for business in the future?*
What do you do outside of work (hobbies, family, interests)?*
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