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7 Over 70 Survey

Please fill out the following survey to be considered for our 7 Professionals Over 70 Years Old. Our editorial team evaluates submissions once a year and looks forward to your submission!

Please fill out the survey as completely as possible to maximize your chances for selection.
Full Name
E-mail Address
Title
Employment Status – Active or Inactive
Legal Company Name
Business Description (20 words or less)
Street Address
City
ZIP Code
Phone Number
Website
Age
Spouse/Partner Name
Where did you complete your undergraduate degree, what was your degree/major, and when did you graduate?
If you have a graduate degree, where is it from, what was your major/degree, and when did you graduate?
What trade, professional, and civic organizations do you belong to? (Please indicate any leadership positions in those organizations.)
What career achievement are you most proud of accomplishing?
What is your business philosophy?
How have you been involved in the Madison community?
What key lesson have you learned that you'd like share?
Who have been the key influencers to your success?
What would you like your legacy to be?
What changes have you observed over the years – in your field or in business in general? Have they made things better or worse, in your opinion?
Do you have any regrets, as you look back??
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You may upload an attachment with your submission. We accept the following file types:
jpg,jpeg,gif,pdf,doc,docx

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