Fillable Form B -EMBA (Wichita State University)

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Form B -EMBA (Wichita State University)

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Country of origin: US
File type: PDF

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Name ___________________________________________________Informal or nickname _________________________________
Home address _____________________________________________________________________________________________
City __________________________________________________________State ________________ Zip ___________________
Preferred mailing address: Home Work
Preferred email address: Home Work
Home telephone number _____________________________________________________________________________________
Date of birth ____________________________________ Place of birth _______________________________________________
Citizenship: • U.S. citizen • Non–U.S. citizen Country of citizenship ___________________________________________
Work Experience
Total number of years of full-time professional employment __________________________________________________________
Total number of years of managerial experience ___________________________________________________________________
Please attach current resumé.
Include information on professional awards and achievements. Please list distinctions, honors and awards for academic achievement or
community service. Also list the names of professional or volunteer organizations, clubs, athletics or other community activities in which you
are involved.
Current position data:
Title ______________________________________________________________________________________________________
Company _________________________________________________________________________________________________
Address __________________________________________________________________________________________________
City _____________________________________________________________ State _________________ ZIP _____________
Office telephone number _________________________ Office fax number ______________________________________________
Email address _____________________________________________________________________________________________
Current salary range:
Is your company is a subsidiary, division or affiliate? Yes No
If yes, please indicate the parent company's name _________________________________________________________________
Nature of Business _________________________________________________________________________________________
Form B
APPLICATION FOR ADMISSION TO EXECUTIVE MBA PROGRAM
Wichita State University
W. Frank Barton School of Business
continued
Work Experience
below $70,000 $70,000-$125,00
$125,000+
Years in position ____________ Duties________________________________________________________________________
Name and title of immediate supervisor_________________________________________________________________________
Number of people you directly supervise _______________________________________________________________________
Dollar value of assets under your control ______________ and/or dollar value of sale you manage__________________________
Please select the category that best describes your professional function (all that apply):
• Finance/Accounting • Marketing/Sales • Real Estate/Development
• General Management • MIS/IT • Consulting
• Education • Human Resources • Operations/Logistics
• Engineering • Legal • Other________________
Please select the category that best describes the industry in which you work:
• Consulting • Consumer Products • Financial Services • Government
• Manufacturing • Media/Entertainment • Non-profit • Energy
• Real Estate • Technology • Health Care • Agribusiness
• Other ___________________
Essay requirement
Please address the following questions in one essay (minimum 500 words). This will help the admissions committee understand your
motivation for applying to the Barton School Executive MBA program.
1.
What are your career objectives?
2.
What do you expect to accomplish through this Executive MBA program? What learning experiences do you expect
and how would you apply them?
How did you learn about our program?
Executive MBA brochure
WSU Barton School website
Advertisement (specify source): ________________________________
Previous participant (name): ___________________________________
Human resource director (name): _______________________________
Manager (name): ____________________________________________
Other (please specify): ________________________________________
Applicant's agreement: I affirm that all information on this application is complete and accurate.
Signature of applicant ______________________________________________________ Date of application _____________________
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Form B -EMBA (Wichita State University)

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Completed 23 July 2020

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