ASSOCIATION OF PUBLIC TREASURERS

of the UNITED STATES and CANADA

APPLICATION FOR CONSIDERATION

2010/2011 APT US&C BOARD OF DIRECTORS

NAME:
__________________________________________________________________

ADDRESS:
__________________________________________________________________

PRESENT EMPLOYER:
__________________________________________________________________

TITLE: YEARS OF SERVICE:

DUTIES:
________________________________________________________________

________________________________________________________________

PHONE: ___________________________ FAX: __________________________

EMAIL: ___________________________________________________________

1. Do you presently hold an office in APT US&C? Yes _____ No _____

If yes, which position?

____________________________________________________________

2. Number of years you have served on the APT US&C Board and positions?

____________________________________________________________

3. Position(s) you prefer to be considered for: (select no more than two, and
Number them 1 and 2). .

( ) President-elect ( ) Vice President ( ) Secretary

( ) Treasurer ( ) Director
 PAGE (2)

4. Do you presently hold an office in a state association? Yes ______ No______

If yes, which position?

____________________________________________________________

5. Past / Current and State APT or other Treasurer Associations elective offices
(list office and year elected):

____________________________________________________________

6. APT US&C Committees:

Committee (year (s) Position (Chair, Vice-Chair, Member)

____________________ _________________________________

____________________ _________________________________

____________________ _________________________________

7. How many years have you been a member of APT US&C? _____ years

8. How many APT US&C Annual Conferences have you attended? _____
List Years: _________________________________________________
__________________________________________________________

9. List membership and participation in other professional organizations (state

CPA’s, cash management association, GFOA, etc.):

__________________________________________________________________

__________________________________________________________________

10. List credentials (CPFA, CPA, etc.):

__________________________________________________________________

__________________________________________________________________
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(QUESTIONS 11 & 12 MAY BE ANSWERED BY ATTACHING YOUR RESUME)

11. Degrees held. Do not abbreviate. Example: Bachelor of Science,

Mathematics, Finance, Bachelor of Business Administration.

__________________________________________________________________

__________________________________________________________________

12. Past Employer: ___________________________________

Title: ___________________________________________

Duties: __________________________________________

Dates: _________________________________________

Past Employer: ____________________________________

Title: ____________________________________________

Duties: ___________________________________________

Dates: ___________________________________________

13. Why do you seek an elective office in APT US&C? (You may attach a
separate page.) ________________________________________________

_______________________________________________________

_______________________________________________________

14. What are your recommendations for the future of APT US&C? (You may
attach a separate page.) __________________________________________

_________________________________________________________

_________________________________________________________
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15. Will you be able to attend two (2) mid-year Board of Directors meetings and
Board meetings held before and after the Annual Conference at the expense of
your government entity or your personal expense? NOTE: The Association pays all
air/ground and hotel expenses in excess of $200 per board meeting.

Yes _____ No _____

NOTE: The Association does not pay any expenses for board members
attending the annual conference.

16. Have you ever been a speaker or moderator at an APT US&C conference?

Yes _____ No _____

If yes, which year(s)? What topic(s)?

____________________________________________________________

17. Would you be willing to be a speaker or moderator at an APT US&C

conference?

Yes _____ No _____

18. In order to provide affordable registration for the Annual Conference it is

necessary for the members of the Board of Directors to help identify and contact
sponsors to raise these sponsorship dollars, will you help in this effort?

Yes _____ No _____

If your answer is Yes, Please list three new potential sponsors you will
contact.
_________________________________________________________

_________________________________________________________

_________________________________________________________

If your answer is No, please explain:

_________________________________________________________

_________________________________________________________
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19. Have you ever prepared material for an APT US&C publication?
Yes _____ No _____

20. There have been occasions when a person has been nominated and elected to
the Board, but their government entity (Mayor, Council , Commission and / or
Manager) has not financially and administratively supported them to effectively
participate and to attend Board meetings.

“TO ASSIST THOSE WHO ARE APPLYING FOR A POSITION ON THE APT
US&C BOARD OF DIRECTORS, WITH THE EXCEPTION OF THOSE
APPLICANTS WHO HOLD AN INDEPENDENTLY ELECTED OFFICE, A
LETTER FROM YOUR GOVERNMENT ENTITY SHALL BE SUBMITTED WITH
YOUR APPLICATION STATING ADMINISTRATIVE AND FINANCIAL
SUPPORT OF YOUR ACTIVE BOARD MEMBERSHIP.”

Letter Enclosed ______ Letter Not Enclosed ______

Please submit applications by June 7, 2010 to:

Nominations Committee
c/o APT US & C
962 Wayne Avenue. Suite 910
Silver Spring, MD 20910
Office: (301) 495-5560
Fax: (301) 495-5561

No fax copies please.

Consideration will only be given to original applications.

SIGNATURE: ________________________________ DATE: ______________