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7 Over 70 Survey

Please fill out the following survey to be considered for In Business magazine's 7 Over 70, an annual feature showcasing 7 influential leaders over the age of 70.

Note: Submission deadline to be considered for the next class is December 31.

* indicates required field
Full Name*
Title
What is your current employment status?*
Active
Retired
Company*
Company Address*
City*
State*
Zip Code*
Phone Number*
E-mail Address*
Web Site
Company Description (8 words or less)*
Position Description*

Personal Data

Age*
Spouse/Partner Name

Education

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

Business Board of Director Memberships

Company, Title (Limit 3)

Professional & Civic Organizations

Organization, Title (Limit 3)

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

Provide a brief overview of your most recent postions/responsibilities with your company*
What are the hallmark achievements of your career?*
What is your business philosophy? What is your personal philosophy (if different)?*
How have you been involved in the community or served as a company catalyst for involvement in the community?*
What is the hardest lesson you have learned?*
Who or what has most influenced your career? (Please explain as fully as possible)*
What legacy do you hope to leave?*
Please feel free to provide any other work history or information that you'd like us to consider as part of your submission.
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