THE SENIOR EXECUTIVES ASSOCIATION THE VOICE OF CAREER FEDERAL EXECUTIVES SINCE JOIN TODAY!

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1 THE SENIOR EXECUTIVES ASSOCIATION THE VOICE OF CAREER FEDERAL EXECUTIVES SINCE JOIN TODAY!

2 WHAT IS SEA? The Senior Executives Association is a nonprofit professional association that promotes ethical and dynamic public service by fostering an outstanding career executive corps, advocates the interests of career Federal executives (both active and retired), and provides information and services to SEA members. VISION SEA is considered the world s preeminent center of excellence serving the professional needs of the Federal government s career leadership corps, which is universally recognized as forward thinking, entrepreneurial, accountable and serves the national interest with the highest professional standards. MISSION SEA promotes policies and programs that empower its constituent members to accomplish their vital mission responsibilities as well as advance their personal professional development. CORE VALUES A passion for public service leadership exhibiting the highest standards of integrity, professional excellence, and accountability.

3 AM I ELIGIBLE? To broaden participation in SEA, Participation Categories are now offered, in addition to Member Categories. Read the descriptions below and choose the one that suits you best. MEMBER CATEGORIES ACTIVE MEMBER Individuals who are SES, Senior Level (SL), Scientific and Professional (ST), or equivalent are eligible for full membership in SEA. Additionally, GS-14/15 or equivalent who meet any of the following criteria are eligible: Equivalent executive responsibilities, positions subject to centralized control of their agency's Executive Resources Board, completed an agency executive development program/course, or attended the Federal Executive Institute. RETIRED MEMBER Individuals who are former executives that either retired or left government are eligible for membership as a retiree. PARTICIPATION CATEGORIES Participants cannot vote or assume SEA leadership roles on the Board of Directors or Communities of Change (CoC). ASSOCIATE GS-14/15 s who are not eligible for full membership in SEA will be nominated by an SEA member. RISING LEADER GS s will be nominated by an SEA member and are identified as rising stars within the Federal government (PMF, Pathways, agency-specific leadership programs, SEA/YGL Mentor/Protégé Program, etc.) AFFILIATE GS-12 to 15 s who self-nominate for participation.

4 Salutation: Dr. Mr. Ms. Mrs. Miss Full Name: Date of Birth: Gender: Female Male Job Title: Office Address Office Name: Agency: Room #: or Mail Code: Address: City: State: Zip +4: Phone: Fax: Home Address Address: Apt. #: City: State: Zip +4: Phone: Congressional Dist: Send all mail from SEA to my: Office Address Home Address We strongly encourage members to use their home address since mail sent to an office is often delayed or misplaced. Send all from SEA to my: Office Home

5 Member Categories Active Member SES Senior Level (SL) Scientific & Profesional (ST) Equivalent Pay System, please specify: Eligible GS-14/15 or equivalent who meet any of the following: Equivalent executive responsibilities Positions subject to centralized control of agency s Executive Resources Board Completed an agency executive development program/course Attended the Federal Executive Institute Retired Member Former Executive (retired/left government) Former agency: Former job title: Participant Categories Participants cannot vote or assume SEA leadership roles on the Board of Directors or Communities of Change. Associate GS-14/15 s not eligible for full membership & are nominated by an SEA member. Rising Leaders GS s nominated by an SEA member and identified as rising stars within the Federal government (PMF, Pathways, agency-specific leadership programs, SEA/YGL Mentor/Protégé Program, etc.) Affiliates GS-12 to 15 s who self-nominate for participation. Member Sponsor (if any): Presidential Rank Award Have you ever received a Presidential Rank of: Distinguished Executive Meritorious Executive Year(s): Year(s): SEA Chapters If you d like to join a chapter, please write the chapter name below.

6 Communities of Change Please indicate which CoC you would like to join. Check all that apply. Acquisition Cyber Fiscal Accountability National Security Governance Innovation Human Capital/Leadership Are you interested in a leadership position within a CoC? Yes No Maybe Privacy Guarantee SEA regularly publishes new member names in SEA s monthly newsletter, ACTION. Would you like SEA to print your name? Yes No Interest in SEA Why did you decide to join SEA? Please check all that apply. To support lobbying efforts To support SEA s good government efforts For up-to-date information Encouraged by a member For the membership benefits Encouraged by correspondence Other (please explain): SEA Dues *Pursuant to the Omnibus Budget Reconciliation Act of 1993, 35% of dues is attributable to nondeductible lobbying activity and is, therefore, not deductible under Internal Revenue Code Section 162 as an ordinary and necessary business expense. Active Member Annual Dues: $293 by check, $299 by credit card This amount reflects a 10% discount as incentive to pay annually. Payroll withholding: $12.50 per bi-weekly pay period Your membership is effective upon receipt of your first dues payment. SEA will mail you the required agency form and instructions to begin this process. Retired Member Annual Dues: $100 by check, $103 by credit card Lifetime Membership: $945 This membership is non-transferrable and non-refundable.

7 Payment Check, payable to SEA. Please indicate enclosed amount: $ AMEX VISA MasterCard Discover Card Number: Expires: / Security Code (4-digit for AMEX, 3-digit all others): Check this box for automatic renewal. SEA will automatically charge your annual membership dues to your credit card on the first business day following the day your membership expires. You may cancel at any time. Thank you for supporting the Senior Executives Association. Please sign and date below. Signature: Date: Please send your application to: Senior Executives Association Attn: Membership Services 77 K Street NE, Suite 2600 Washington, D.C Or fax it to: Check out the SEA Store! stock up on the best SES, SL, and ST swag seniorexecs.org/online-shop For Office Use Only SC