Registration Form

 
*This information will be retained by the MIS Advisors and will not be made available to anyone without your express approval.
 
       
 
*Name
 
       
 
Organization/Company Name:
 
       
 
Title / Position
 
       
 
Company Address
 
       
 
Phone
 
       
 
Fax
 
       
 
*Email
 
       
 
Company Website
 
       
 
Brief description of job functions
 
       
 
Previous Experience
 
       
 
I am willing to do the following with the MIS Club: (check all that apply)
   
       
 
e-mail
 
 
Phone
 
 
In-Person
 
 
Internship
 
 
Host a group visit / tour
 
 
Speak at a meeting
Topic  
 
Provide a photo for the website
 
 
Other
 
       
       
       
  *Required Fields  
       
 
 

 

 

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