To ensure we have current and accurate records, please complete the form below. All information is kept strictly confidential.

Bio and Headshot

If your executive’s bio or headshot have changed in the past year, please send the current version(s) to jcp@columbuspartnership.com.

CEO's Name

First Name

Last Name

Pronouns

He/Him/His

She/Her/Hers

Ze/Hir/Hirs

They/Them/Theirs

No Pronoun

No Preference

Not Listed

Company/Organization Name

(Legal/formal company name preferred for listing in our materials.)

Board Affiliations

Please list any boards or professional councils that the member currently sits on.

Regional FTEs

Please list how many full time employees currently work in the Columbus Region (across all local facilities).

Current rank on the Fortune 1,000 list (if applicable)

Home Address

Please complete only if this has changed in the past year.

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Dietary Preferences

Any changes to the executive's or their spouse's dietary restrictions in the past year?

Have you (the CEO) ever served in the U.S. Armed Forces, military Reserves, or National Guard?

If yes, please clarify branch and any special rankings below.

Yes

No