Chief Deputies/Chiefs of Staff Directory Collection Form

First Name(Required)

Last Name(Required)

Title(Required)

Office(Required)

Address 1(Required)

Address 2(Required)

City(Required)

State(Required)

Zip Code(Required)

Email(Required)

Website Address(Required)

Office Phone

Mobile Phone

Biography(Required)

There is a 150 word limit.

Photo

Please upload a photo of yourself. It will be used with your entry in the directory.

Accepted file types: jpg, png, pdf, jpg, png, pdf, jpeg, jpeg, webp, Max. file size: 50 MB.

If you are submitting an entry for another colleague and would like to receive a copy of their confirmation email, complete the fields below.

Submitter's Name

First Last

Submitter's Email

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