2010 UB McNair Research Conference -- Graduate School Opportunities Fair
1)
Institution/Organization
2)
Program/Department (if applicable)
3)
Program Website Address
4)
How many representatives from your program will be attending?
(Each additional recruiter is only $95!)
Separate registration is required for each recruiter
5)
Representative's First Name
6)
Representative's Last Name
7)
Contact Address
8)
City
9)
State
10)
Zip Code
11)
Representative's Phone Number
12)
Representative's E-Mail Address
13)
Will you be attending dinner after the Fair at 7:00pm on July 17th? (included in registration fee)
Yes
No
14)
If yes, would you prefer a vegetarian meal?
Yes
No
15) Will you need any special accommodations?
(i.e., wheelchair access, etc.)
If yes, we will contact you for further details.
No
Yes (please specify)
If you selected yes, please specify:
16)
Please Select Method of Payment
Credit Card (Please call 716-645-6361)
Check
Money Order
17)
Program Description
Your description will not be accepted if it exceeds the 100 word maximum
Online Survey Software powered by Vovici.