Representative 1

First Name  *                  

Last Name  *                  

Title  *                              

Business Unit/Division  

Address  *                     

Email  *                            

Phone                               

Representative 2 (Optional)

First Name                     

Last Name                      

Title                                  

Business Unit/Division  

Address                         
Email                                

Phone                              

Majors

What majors are you interested in meeting?*

	BS/BA	MS/MEng	PhD
Computer Science (CS)
Electrical and Computer Engineering (ECE)

Are you interested in hiring interns?*

Please Select Yes No

Company Information

Company Name  *

Career Website  *

What does your company make/do?  *   A short description. Max 150 words.

Office @ Event*             

Other Offices               

Comments/Questions

Invoice

Do you need an Invoice?  * Please Select Yes No
Where should we send your invoice?

Name                      
Address                  
Email