Company Information:

Company:

Address:  
               

City:    State:    Zip:

Phone: - - / Web Address:

Number of Employees: Under 10 / 10 to 49 / 50 to 99 / 100+

Business Hours:

Contact Person:

Name:
Last: First: Middle Initial:

Title:

Phone: - - / Fax: - -

e-mail:

Describe your business briefly,
including the occupational areas of your staff:

Our company can supply the following:

Printed Materials Audiovisuals Equipment and/or Supplies

Special Library Teacher Training Student internships

Field trips Shadow experiences Web Site

Our company can also provide individuals to participate as:

Tutor Mentor Consultant Judge

Career Interview Student Internships Shadow Experiences Student Field Trip

In-Depth Tour Teacher Opportunities:       School Year       Summer

Speakers		Topic

Our company prefers to have all requests made:
Through our Speakers Bureau
Through our main contact
Directly to individuals who volunteer