Emerging Leaders Program Application

First Name

Last Name

Email

Job Title

Number of Years in the Profession

Company

Address

City

State

Zip

Business Phone

Why do you feel this person is qualified to be an Emerging Leader?

Is this person someone you would anticipate sending to CCH Connections: User Conference in the future, to represent your firm, network with peers on solutions being considered, and bring back best practices tips to share with others in your firm? YesNo

Nominee First Name

Nominee Last Name

Nominee Email

Nominee Job Title

Name of Wolters Kluwer Representative

Key Attribute Checklist (select one or more) Technically competentMentors othersForward thinkingExceptional communicatorStrong sense of client serviceDesire to bring in new businessEager to advanceActive in the communityComfortable working with all levels within the FirmExhibits interest in success of the FirmReliableTrustworthyActive in social media

Date Submitted

Comments

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