Dr. Bill Winston Addresses the JBS Alumni on December 13, 2012. Event will start at 6:30 pm and be held at the Training Center at the Forest Park Mall

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* 1. Will you be attending this event?

Yes

No

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* 2. Whether you are able or not to attend the event, please give us the following information so that we can update our records and keep you aware of upcoming Alumni events and opportunities

First and Last Name:

Company Name:

Address:

Address 2:

City/Town:

State:

ZIP:

Country:

Preferred Email Address:

Phone Number:

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* 3. This is a JBS Alumni event only. Therefore, please give your graduation date (month and year).

Month

Year

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* 4. In which industry is your business or intended business? For example, IT, medical, childcare, food, etc.

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* 5. Have you started a business?

Y

N

If yes, please provide the name, location and length of operation of your business.

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* 6. There will be a Q&A session with Dr. Winston. If you have a question for Dr. Winston, please type below: