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About Your Organization
Name of Organization
*
Name of Affiliated Organization if Different than Above
Organization Mailing Address
*
Address Line 1
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
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Iowa
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Maine
Maryland
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Pennsylvania
Puerto Rico
Rhode Island
South Carolina
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Tennessee
Texas
Utah
Vermont
Virgin Islands (US)
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces (the) Americas
Armed Forces Europe
Armed Forces Pacific
Army Post Office (U.S. Army and U.S. Air Force)
Fleet Post Office (U.S. Navy and U.S. Marine Corps)
State
ZIP Code
Phone
*
Fax
Website
Contact Email
*
Name of Representative
First Name
Last Name
Title of Representative
Name of Second Representative
First Name
Last Name
Title of Second Representative
About Your Space at the Exhibition
Do you need electrical outlets?
*
Yes
No
Audio/visual equipment cannot be provided, however you are welcome to bring your own. Electrical outlets are limited and will be assigned on a first come, first served basis as registration forms are received.
Number of outlets required
*
1
2
3
4
5
6
7
8
9
10
Do you require special accommodations?
If you require specific accommodations for a disability or for your presentation, such as space for a large exhibit, please describe it here.
Please check the areas you wish to discuss with students:
General Information
Career Advice
Full-time openings
Volunteer/Community Service
Residency
Part-time openings
Other:
Other Value
Select all that apply.
Please list the top three skill sets you are looking for:
Registration Fee and Payment
Registration Fee
*
Affiliate Employers - $100
Non-Affiliate Employers - $150
If you are interested in becoming an affiliated facility please contact Daniel Maddox at
dmaddox1@brenau.edu
or Heidi Neal at
hneal1@brenau.edu
.
Credit Card Information
Credit Card
*
Name as it Appears on Credit Card
*
Billing Address
*
Address Line 1
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands (US)
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces (the) Americas
Armed Forces Europe
Armed Forces Pacific
Army Post Office (U.S. Army and U.S. Air Force)
Fleet Post Office (U.S. Navy and U.S. Marine Corps)
State
ZIP Code
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