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* 1. Name:

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* 2. Email:

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* 3. Company:

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* 4. Are you a returning connection? 

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* 5. Would you be willing to connect with more than 1 student?

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* 6. What areas of business can you contribute or have experience in?

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* 7. Are you able to meet with a student outside of WIT events in the Fox Valley area or Green Bay?

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* 8. Which activities do you prefer? (Select all that apply)

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* 9. During this program, we will host a meet and greet event. Which of the following days works best with your schedule? (Select all that apply)

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* 10. I agree to provide a worthwhile connection experience for 3 months outlined by WITonCampus

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