| 1. Have you attended UConn’s Agriculture and Natural Resources Career Night before? |
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Yes |
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No |
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| 2. First Name: |
* |
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| 3. Last Name: |
* |
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| 4. E-Mail: |
* |
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| 5. Daytime Phone No. |
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6. Name of employer
(please feel free to also include the name of your department if appropriate)
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| 7. Job title: |
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8. Description of the industry that you work in
(please limit this to 6 words or less if possible): |
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| 9. Are you a UConn alumnus? |
Yes
No |
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| 10. We would like to include information on the degree/s you have earned (both at UConn and elsewhere) in the Career Night program. Please list your degree information below. |
Note: We have provided space for up to 3 degrees. Please email pamela.chudzik@uconn.edu if you have additional degree information that you would like to have included. |
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| Degree 1: |
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| University/College |
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Type of degree
(B.S., M.S., Ph.D, etc.) |
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| Name of Major |
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| Year of Graduation: |
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| Degree 2: |
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| University/College |
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Type of degree
(B.S., M.S., Ph.D, etc.) |
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| Name of Major |
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| Year of Graduation: |
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| Degree 3: |
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| University/College |
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Type of degree
(B.S., M.S., Ph.D, etc.) |
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| Name of Major |
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| Year of Graduation: |
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11. An eight-foot table and tablecloth will be provided for all employers/companies. Please indicate if you are willing to share a table with another employer/company in a related field.
Note: If more than one person from the same company registers, we will be sure to have them all placed at the same table. |
Yes, I will share a table with another company.
No, my company requires its own table. |
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| 12. Please list below any special requests you may have regarding your table/display for Career Night.
For example, please indicate below if you will require electricity or wireless internet access.
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