Company Sign Up

Industry Response Form for 2013 Fall Technical Career Fair
			Thursday, September 12, 2013 12:30 - 4:30 PM
Company Information
Contact Name*:		Email*:
Company*:		Phone*:
Address*:		Fax:
City/State/Zip*:		Website:
Company Description (to be listed in student brochures)*:
Student Program Brochure (will be used in our advertisements) Indicate the majors you seek to interview:
Applied Computer Graphics	Computer Science			Mechanical Engineering
Electrical Engineering	Computer Engineering			Sustainable Manufacturing
Civil Engineering	Construction Management			Management Information Systems
Concrete Industry Management	Mechatronic Engineering			Other:

Registration Fees: $400.00 Includes Table (6ft. x 2.5ft)

Payment Options
Credit Card Payment (Only Visa and Mastercard Accepted) You will be emailed a "Credit Card" invoice, with a number to call for payment. Please list whom to send this to in the box labeled Invoice Contact.		Payment by Check (Payable to "MESA Engineering Program") * You will be sent you an invoice to accompany your payment. If you would like a copy emailed to you, please list whom in the box labeled Invoice Contact.
Invoice Contact:
For security purposes, please type CHICOSTATEMESA, in all caps, in the box below.