Membership application - Association of Governing Boards of

THANK YOU FOR YOUR MEMBERSHIP!
To be eligible, institutions must be accredited (or be candidates for accreditation) by a
regional agency recognized by the Council for Higher Education Accreditation. AGB’s
institutional members are primarily the governing boards of degree-granting universities
and colleges, professional schools, and seminaries and theological schools. Membership
with AGB provides benefits to all voting board members and nine staff members.
INSTITUTION OR SYSTEM BOARD
Institution or Organization Name
Mailing Address
Zip/Postal Code
Country/Region
TelephoneWebsite
Please indicate the best month for AGB to request an updated board list
FULL-TIME STUDENTS
Institution FTE
FTE equals (full-time students for the most recent fall semester/quarter) plus (one-third part-time students)
MEMBERSHIP CATEGORY
■ Governing Board of College,
University, or University System
■ Governing Board of Education Association
■ Nongoverning / Institution Advisory Board
■ Statewide Planning or
Coordinating Board
■ Education Association or other
Nonprofit Organization
CHECK ONE IN EACH GROUP AS APPROPRIATE
■ 2-Year
■ 4-Year
■ 2-Year and 4-Year
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■
Public
Private
Proprietary
K-12 School
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Single Campus Institution
Multi-campus Institution
State System
Single Campus of State System
WITH THIS FORM, PLEASE SEND
• A list of your board members, including their mailing addresses, email
addresses, and committee assignments, with chairs noted. AGB provides
additional services for individuals who serve as chairs or members for the
following committees: academic or educational affairs, development or
fundraising, finance or budget, student services or student life, and
trusteeship or nominating or governance.
• A list of the seven additional institution staff members not included
on the application form, including mailing and email addresses. AGB
recommends including legal counsels, chief academic officers, chief
development officers, chief enrollment officers, chief financial officers,
chief of institutional research, and chiefs of student services.
• If your board governors or coordinates a multi-campus or state system,
a list of campuses and their chief executives.
• A check for annual dues. Annual dues invoices for membership renewal
will be sent to the president’s office unless otherwise instructed.
1133 20th Street N.W.
Suite 300
Washington, D.C. 20036
202.296.8400
[email protected]
www.agb.org/Join-AGB
AGB MEMBERSHIP
CityState/Province
To deliver AGB membership benefits to board members and staff, please provide
mailing address, committee assignments, and email addresses for the board and staff.
Mailing addresses will be used for the direct mailing of AGB’s magazine, Trusteeship.
Email addresses will be used to provide member discounts through www.agb.org.
CHIEF EXECUTIVE
NameTitle
Mailing Address
City
StateZip
TelephoneEmail
Took office as of
NameTitle
Mailing Address
City
StateZip
TelephoneEmail
Beginning of Term
End of Term
BOARD PROFESSIONAL / STAFF LIAISON TO THE BOARD
NameTitle
Mailing Address
City
StateZip
TelephoneEmail
PLEASE SUBMIT RENEWAL INVOICE TO
NameTitle
Mailing Address
City
StateZip
TelephoneEmail
AGB respects your privacy. Information shared will be used to fulfill member benefits only
and is not sold or rented to any outside organization.
AGB MEMBERSHIP
PRESIDING OFFICER OF THE BOARD