Sports Management Institute: Training Today's Athletics Leaders

Full Name

Informal

Organization

Business Address

Home Address

Business Phone

E-mail Address

Home Phone

Business Fax

Your Title

Your Supervisor's Title

Years with Organization

Years in Present Position

Briefly describe the nature of your job responsibilities.

Please list your experience over the past 10 years, excluding your present position.

Educational Background

Degree

Institution

Specialization/Date Earned

Degree

Institution

Specialization/Date Earned

Degree

Institution

Specialization/Date Earned

NACDA Management Institute Levels attended

Please state what you expect to gain as a result of attending the SMI Executive Program.

Billing Information/Send invoice to:

Name

Title

Name of Organization

Address

Telephone

Upon acceptance to the program an invoice for the deposit of $1,125 will be sent to the participant. The final balance of tuition ($2,000) will be due by May 1, 2012. Cancelations after April 1, 2012 will forfeit the deposit of $1,125.

Sports Management Institute Executive Program Application