Eleventh Annual Alliance Day October 16, 2012 Recruiter Registration Survey

Recruiter registration fees for the Eleventh Annual Alliance Day 2012 are $350. Upon completion of this form, you must follow the links to submit payment. Only upon completion of this form and payment receipt is your spot confirmed. Recruiter registration deadline is September 21, 2012. We will allow for recruiters to set-up between 7-10:00am. The allotted time slot for students to speak with recruiters will be from 10:30am-12:00pm and 1:30-4pm. A 6 ft. table will be provided in a designated area for recruiters. We will also provide lunch to all recruiters. Directions and hotel information can be found on the NC OPT-ED Alliance Day Website.

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1. College/University Name (as it will appear on all documents)

College/University Name (as it will appear on all documents)

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2. City and State of College/University

City and State of College/University

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3. Full Name of Recruiter (as it will appear on name tag)

Full Name of Recruiter (as it will appear on name tag)

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4. Email address

Email address

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5. Daytime Phone Number

Daytime Phone Number

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6. What academic level will you be recruiting?

What academic level will you be recruiting? Undergraduate

Graduate

Both

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7. Would you like lunch?

Would you like lunch? Yes

No

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8. Will an additional staff/faculty member be accompanying you?

Will an additional staff/faculty member be accompanying you? Yes

No