MissouriFBLA State Officer Application 2018-19

Name: Adviser: Office(s) Sought:

School: School System:

Two (2) sets of a completed application packet must be RECEIVEDby Wednesday, January 31 at 5:00pm. Mail to: Missouri FBLA, State Officer Application, PO Box 480, Jefferson City, MO 65102 (it is recommended that you send using some tracking method). If sending via FedEx/UPS, use the physical address of 205 Jefferson St., Jefferson City, MO 65101. Any application not in the state office by this time will be disqualified automatically. You should retain a copy of your entire signed application for your records. A completed application set consists of the following items completed in full:

Application Form: Missouri FBLA District:

Appendix A: Duties of FBLA State Officers (signed by candidate, adviser, and parent)

Appendix B: Duties of FBLA State Officer Adviser (signed by candidate and adviser)

Appendix C: School Certification Form (signed by adviser, candidate’s parent, school principal, Career Center director (if applicable), and school system superintendent/designee)

Appendix D: Medical Release Form (include copy of health insurance card)

Appendix E: Adviser Assurance Form (signed by adviser)

Appendix F: Officer Uniform Sizes Form

Appendix G: Officer Travel Permission Form

Appendix H: Officer Commitment and Funding Form

Each essay should be no more than 300 words and must follow the FBLA Format Guide format for a left-bound report.

Essay 1: Explain why you want to be a Missouri FBLA State Officer and what you hope to receive from this experience. Include a description of why you decided to run for state office.

Essay 2: Explain what you feel the state officer experience is all about.

Essay 3: Explain how the FBLA activities in which you have participated have increased your qualifications to serve as a Missouri FBLA state officer.

Essay 4: Describe the role you have played in your local chapter’s membership recruitment efforts and how that will assist you to drive the state chapter’s membership recruitment efforts.

Essay 5: Explain how the state officers can and should assist local chapters in their development.

Resume of candidate not to exceed two (2) pages which lists qualifications for office and involvement on the local, state, and national levels

Statement of proposed platform for office not to exceed three (3) pages

Letter of recommendation for candidate from principal, Career Center director or superintendent

Letter of recommendation for candidate from head of business department

Letter of recommendation for candidate from adviser who will serve as primary state officer adviser

Letter of recommendation for candidate from community or business leader on applicant’s character

Letter of recommendation for candidate from another individual (optional)

Copy of candidate’s high school transcript (including Fall 2016 grades)

Letter from school administrator concerning candidate’s absenteeism and tardiness

Picture of Candidatein Professional Business Attire (full color picture of candidate in official dress should be scanned onto a 8.5” x 11” sheet of paper – image should be no larger than 4” x 6”)

Business Achievement Award Level Verification:

BAA Certification from national office or copy of completed application for required level(s)

Copy of candidate’s proposed campaign logo and theme

Copy of candidate’s proposed speech

Copy of candidate’s proposed flyer

Copy/Storyboard of candidate’s proposed 30-second commercial

Diagram of candidate’s proposed campaign booth area/design

Picture and/or description of candidate's proposed ONE campaign booth handout item

Budget of planned campaign expenditures, not to exceed $500

The application should be submitted in the order in which they appear above. You must submit two (2) copies of each set of the above items. Both sets should be placed in a single 1 inchwhite, three-ring presentation/view binder, with a divider page separating the two copies of the application. Do not place pages in sheet protectors. You must include a CD that contains a copy of this application (completed but without signatures) and all essays, platform, resume saved in Microsoft Word. The CD should be labeled with candidate’s name and school.

This page must be inserted in the front cover display on the presentation binder.
FBLA State Officer Application – 2018-19

Name of Candidate: School:

Members wishing to apply for state office must complete this application and get it certified by principal and county superintendent. APPLICATION MUST BE RECEIVEDbyJanuary 31, 2018 at 5:00pm. Faxed or e-mailed copies will NOT be accepted.

Please fill out the items below completely. Applications should be typed and printed. NOT HANDWRITTEN!

I.Personal Information

  1. Applicant’s Full Name:
  2. If officer goes by another name, list that here:
  3. Date of Birth:
  4. Home Mailing Address:

HomeCity, State, Zip:

  1. Home Phone:
  2. Cell Phone:
  3. Personal Email Address:
  4. Number of years as a high school FBLA member (including this year):
  5. Grade during 2018-19 School Term:Sophomore Junior Senior
  6. FBLA Offices held and term of office:
  1. Business & Computer Science courses completed or currently enrolled in:

II.Chapter Information

  1. School Name:
  2. Chapter #:
  3. School Address:

City, State, Zip:

  1. School Phone:
  2. School Fax:

Name of Candidate: School:

III.Adviser(s) Information (List only those advisers who will serve as state officer advisers)

  1. Primary Adviser’s Name: (prefer having same adviser travel with officer at all times)
  1. Adviser’s Home Address:

City, State, ZIP:

  1. Adviser’s Home Phone
  2. Adviser’s School E-mail:
  3. Adviser’s Home E-mail:

Additional Advisers who may also be traveling with state officer:

  1. Adviser’s Name:
  2. Adviser’s Home Address:

City, State, ZIP:

  1. Adviser’s Home Phone:
  2. Adviser’s School E-mail:
  3. Adviser’s Home E-mail:
  1. Adviser’s Name:
  2. Adviser’s Home Address:

City, State, ZIP:

  1. Adviser’s Home Phone:
  2. Adviser’s School E-mail:
  3. Adviser’s Home E-mail:

Name of Candidate: School:

IV.Candidate FBLA Participation

Please check the box for the conferences that the candidate was registered for and attended:

Note: Only those conferences where you attended as an official FBLA or ML member count. Conferences attended as a guest (i.e., if your family members attended and you went along) do not count toward qualification.

School Year / ELC/CLUE / SMLC / NFLC / DLC / SLC / NLC
2017-2018 / N/A / N/A
2016-2017 / (Anaheim)
2015-2016 / (Atlanta)
2014-2015 / (Chicago)
2013-2014 / (Nashville)
2012-2013 / N/A / (Anaheim)

Please list all FBLA competitive events in which you have competed and specify the place you received, if applicable (list only those places in which you were recognized during the awards program). Only list official FBLA competitive events (refer to the Chapter Planning Guide or Competitive Event Guidelines for a list of official competitive events). If you competed at DLC, SLC, and/or NLC in the same event, please list these on separate rows.

Name of Event (one event per row) / DLC/SLC/NLC / Year / Place Received

*APPENDIX A*

DUTIES OF FBLA STATE OFFICERS

Name of Candidate: School:

The State Officer shall:

  1. Attend all FBLA meetings, workshops, and conferences on the local, regional, and state levels;
  2. Serve as a delegate at the National Leadership Conference;
  3. Submit all assignments by the stated deadline;
  4. Promote MissouriFBLA through the visitation of schools, businesses, etc.;
  5. Wear official dress when requested by State Adviser;
  6. Assume responsibility for implementing the Program of Work
  7. Make arrangements for transportation to all events;
  8. Represent the State Chapter at functions such as MissouriAssociation for Career & Technology Education, and other various functions;
  9. Maintain an up-to-date mailing list of every chapter in area;
  10. Recruit members for local chapter;
  11. Assist in state membership recruitment efforts and campaigns;

The following activities are REQUIRED of all state officers for 2018-19:

Conference / Required For / Date / Location
Executive Leadership Retreat (ELR) / State: FBLA, ML, PBL / May 31-June 3, 2018 / Jefferson City, MO
NLC Bootcamp / State: FBLA, ML, PBL / June 3, 2017 / Jefferson City, MO
PBL National Leadership Conference (NLC) / State: PBL / June 23-26, 2018 / Baltimore, MD
FBLA National Leadership Conference (NLC) / State: FBLA / June 28-July 1, 2018 / Baltimore, MD
Creating Leaders & Unleashing Excellence (CLUE) / State: FBLA, PBL / July 15-19, 2018 / Various Locations
Show-Me Leadership Conferences (SMLC) (only one) / State: FBLA, ML, PBL / September 29, October 6, 13, 2018 / 29: Worlds of Fun
6: Six Flags
13: Silver Dollar City
National Fall Leadership Conference (NFLC) / State: FBLA, ML, PBL / November 2018 / TBD
PBL State Planning Meeting / State: PBL / January 2019 / Springfield, MO
District Leadership Conference (DLC) / State: FBLA / February 2019 / Various Locations
CTSO Legislative Day / State: FBLA / February 2019 / Jefferson City, MO
FBLA State Planning Meeting / State: FBLA / February 22-24, 2019 / Jefferson City, MO

I understand that failure to comply with the officer responsibilities listed above will result in termination of office per the Foundation Board. I understand that I must attend all required functions above and will not receive permission to miss any of these meetings. Should I leave office prior to the completion of my term, I agree to reimburse Missouri FBLA for the costs associated with the purchase of my uniform. I will assist at all of the Missouri FBLA conferences and the executive council meetings in any manner requested by the state adviser.

Signatures:

Adviser(s)

Candidate

Parent

Date

*APPENDIX B*

DUTIES OF FBLASTATE OFFICER ADVISERS

Name of Candidate: School:

The Adviser shall:

  1. Attend all Executive Council Meetings and other business meetings of the State with the officer;
  2. Attend all FBLA meetings, workshops, and conferences on the local, regional, and state levels;
  3. Assist the officer in carrying out his/her duties;
  4. Assist in Executive Leadership Conference, Show-Me Leadership Conference, District Leadership Conference, MiddleLevelState Leadership Conference, PBL State Leadership Conference and the FBLA State Leadership Conference;
  5. Provide or arrange transportation for the officer from his/her school;
  6. Have access to email at home and school;
  7. Apply for extended day pay, if desired and eligible;

Given the nature of being a state officer adviser and the training that is provided at each meeting, it is STRONGLY RECOMMENDED that the same local chapter adviser travel with the student to all Executive Council meetings.

Signatures:

Adviser(s)

Candidate

Date

*APPENDIX C*

SCHOOL CERTIFICATION FORM

Name of Candidate: School:

Date:

To:Chris Dzurick, Missouri FBLA-PBL State Adviser & Foundation Board Executive Director

From: (type name)

, Superintendent or Designee

, System Career Center Director (if applicable)

, Principal

, Adviser(s)

, Parent(s)

, School

The credentials for , who is the choice of our chapter, are attached. To the best of our knowledge, this individual meets the qualifications for Missouri FBLA state office and, if elected, will receive the enthusiastic support of the school, chapter, and the adviser in execution of the duties of the office.

As administrator, I agree to provide travel money for the adviser(s) to carry out the tasks of the office for which the FBLA member is a candidate.

Signed,

Superintendent or DesigneePrincipal

School System Career Center DirectorAdviser(s)

Adviser(s)Parent

Please note that if any of the individuals listed above leave their roles from the time of application throughout the term of office, the individual(s) replacing the individuals listed above will be required to sign this application as well.
*APPENDIX D*

MEDICAL RELEASE FORM

Name of Candidate: School:

If my child is elected an FBLA State Officer, I understand that this honor requires him/her to attend a variety of mandatory activities to represent his/her school and the State of Missouri. I will support my child in all of these endeavors.

Likewise, for his/her protection, I hereby authorize my child’s local chapter adviser and/or the FBLA State Adviser, to sign in my absence for any emergency medical treatment or hospitalization, to order injection, anesthesia, or surgery that my child should need when he/she is attending FBLA activities this year.

I understand that my child’s local chapter adviser, state adviser, and Missouri FBLA-PBLcannot be held liable for any accident or injury that my child may incur while attending an FBLA activity this year.

Student Name:

Office:

School:

Special Medical Needs/Medications Taken

  • PHOTO COPY MEDICAL CARD HERE: (FRONT AND BACK)

Name of Medical Insurance Company

Number of Policy/Contract/Insurance Card

*APPENDIX E*

Adviser Assurance Form

Name of Candidate: School:

I will ensure that my State Officer is supervised at all times. If I am unable to chaperone my student, it is my responsibility to make the necessary arrangements for another adviser to chaperone my student. I am responsible for the actions and behavior of my State Officer. I understand that I am required to be at conferences at all times that my officer is present.

I will ensure that my State Officer fulfills all of his/her duties, as defined by FBLA guidelines and the leadership of the Missouri Future Business Leaders of America, Inc. I will ensure that my student attends all mandatory events and is on time, prepared academically, and in the appropriate business attire. I will also ensure that my student completes all assignments in a timely fashion and at a high quality.

As an adviser to a State Officer, I understand I am expected to assist in workshops, conferences, and competitions in a variety of duties which will be outlined for me by FBLA guidelines and the leadership of the Missouri FBLA-PBL.

As an adviser to a State Officer, I am planning on remaining in my position for the 2018-19school year.

Signature of Adviser(s)

School Name

Officer Name

*APPENDIX F*

Officer Uniform Sizes Form

Name of Candidate: School:

Gender: Male FemaleHeight:

These measurements will be used to order your state officer uniform. Please ensure that measurements are complete, correct, and accurate. You must get measured by a professional rather than relying on current sizes and measurements.

For Male Officers:

You must go to a tailor or men’s clothing shop to be measured. Do not rely on current measurements.

Polo Shirt:T-shirt Size:

Size (S, M, L, XL): Size (S, M, L, XL):

Pants:

Waist Size (enter number): (example – 34)

Inseam Size (enter number): (example – 32)

Suit:

Jacket size (enter number & coat length): (example – 38 Short or 40 Regular or 42 Long)

For Female Officers: Check here if petite sizes are needed.

Polo Shirt:T-shirt Size:

Size (S, M, L, XL): Size (S, M, L, XL):

Pants:

Size (enter number): (example – 8)

Suit:

Jacket size (enter number): (example – 8)

Measurements:

As sizes often differ among manufacturers, please provide the following measurements to facilitate in get the correct size:

Bust Waist: Hips:

Adviser Polo Shirts: Missouri FBLA provides a complimentary polo shirt and a nametag for advisers.

Name: Male Female Polo Shirt Size: T-shirt Size:

Name: Male Female Polo Shirt Size: T-shirt Size:

Name: Male Female Polo Shirt Size: T-shirt Size:

* APPENDIX G *

Officer Chaperone/Travel Permission Form

Name of Candidate: School:

It is necessary for student officers to travel with their advisers or an adult chaperone to/from required Missouri FBLA functions. Under no circumstances will student officers be allowed to drive themselves or other officers to or from meetings, conferences, activities. All FBLA officers must adhere to their local school’s student transportation and chaperone policies and procedures. Since the local adviser serves as a chaperone for the student officer while the student travels on FBLA business, the adviser and/or designee must stay at the same hotel property as the student on all overnight trips. In instances where a local school policy does not permit a student to travel with a school employee, the parent/guardian must assume responsibility for transporting the student to/from required Missouri FBLA functions. However, in these instances where a parent/guardian transports a student, the presence of the adviser is still required.

Please attach a copy of the completed school documentation pertaining to student travel for school activities – or – complete the form below.

As a school official, my signature below verifies that the above checked modes of transportation comply with our student transportation policy and/or exceptions have been made that will permit this student to attend required functions.

______

School AdministratorTitle/PositionDate

My signature below indicates that I have read and understand the enclosed student transportation policy. In addition, I agree to adhere to the above mode(s) of transportation.

______

Parent/GuardianDate

______

StudentDate

* APPENDIX H *

Officer Commitment and Funding Form

Name of Candidate: School:

Individuals who are selected to serve as Missouri FBLA state officers are expected to attend all required meetings, prepare for conference duties (general session speaking parts, workshop assignments, etc.), promote an active local chapter, and complete regular and specific state officer assignments. These expectations are outlined in page 6 of the State Officer Candidate Packet. State officers are expected to adequately balance these state officer responsibilities with their academic and other personal obligations.

In exchange for the work a typical state officer completes during the year, Missouri FBLA agrees to cover the expenses for this state officer, which includes complimentary conference registration fees and travel fees (these may include transportation to national events, meals within the state of Missouri, and lodging cost). However, the state officer, adviser, and parent understand that failure to complete the required obligations of serving as a state officer may result in the state officeno longer covering these expenses on behalf of the officer.

We agree and understand that if the candidate is selected to serve as a state officer, he/she will attend all required meetings in full and complete all required assignments and responsibilities associated with serving as a state officer. We further understand that failure to complete these assignments and responsibilities may result in the officer having to cover the expenses otherwise provided by Missouri FBLA. These expenses may include registration fees, lodging fees, meals, transportation costs, and other expenses paid by Missouri FBLA on the officer’s behalf. Officers who are extremely negligent in their duties may be required to reimburse Missouri FBLA for expenses already incurred (these will be outlined in any probationary letter sent to the officer).. We also understand that repeated failure to meet expectations or failure to attend all required meetings may result in the officer being removed from office.