Organization Sign-Up

1. Organization Sign-Up for Project Connect

If you are part of an organization that is participating in Project Connect, please take a few moments to provide us with some important information.

Contact information provided will be included in a Project Connect Event Brochure that will be given to participants on the day of the event.

1. Please provide contact information:

Please provide contact information: Your Name
Organization Name
Your Organization's Website
E-Mail
Phone Number
Name(s)of representative(S)who will attend Project Connect

2. Addtional information for the Project Connect Resource Phamplet:

Addtional information for the Project Connect Resource Phamplet: What is the mission of your organization?
Do you want your organization's logo included in the resource phamplet?
Is there any addtional information you want included in the resource phamplet?

3. What service or services does your organization provide?

What service or services does your organization provide?

4. What will you need to provide services at Project Connect?

What will you need to provide services at Project Connect? Table

1 chair

2 chairs

3 chairs

Electricity

Internet Access

Fax Machine

Printer

Photocopier

Access to private space

A booth set up in a private space (as opposed to the open gym area where most organization's booth's will be)

A booth set up outside under a tent

Other needs (please specify)

5. Do you want someone from the Project Connect planning team to call you to further discuss your involvement at the event?

Do you want someone from the Project Connect planning team to call you to further discuss your involvement at the event? YES

6. What is generally a good time to contact you?

	Any Time	8AM-11AM	11AM-1PM	1PM-5PM
Monday	What is generally a good time to contact you? Monday Any Time	8AM-11AM	11AM-1PM	1PM-5PM
Tuesday	Tuesday Any Time	8AM-11AM	11AM-1PM	1PM-5PM
Wednesday	Wednesday Any Time	8AM-11AM	11AM-1PM	1PM-5PM
Thursday	Thursday Any Time	8AM-11AM	11AM-1PM	1PM-5PM
Friday	Friday Any Time	8AM-11AM	11AM-1PM	1PM-5PM
Any Time	Any Time Any Time	8AM-11AM	11AM-1PM	1PM-5PM

7. Are there any other providers/organizations you can suggest for this event? Please list:

Are there any other providers/organizations you can suggest for this event? Please list:

8. Are there any providers/organizations you'd like to be placed next to at the event? If so, please list:

Are there any providers/organizations you'd like to be placed next to at the event? If so, please list: