SEEDS Advertisement Registration Form

1. Opportunity information

Question Title

* 1. How would you like to advertise your opportunity with the ESA-SEEDS program?

Ad in SEEDS Newsletter (6000+ contacts) - One time ($200)

Ad in SEEDS Newsletter (6000+ contacts) - Full Year ($750)

Ad in SEEDSNouncements (2500 contacts) - One Month ($50)

Ad in SEEDSNouncements (2500 contacts) - Two Month ($75)

Ad in SEEDSNouncements (2500 contacts) - Three Months ($100)

Fall Semester Ad in SEEDSNouncements - Aug-Dec ($125)

Spring Semester Ad in SEEDSNouncements - Jan-May ($125)

Other (please specify)

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* 2. Organization or Company name:

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* 3. Opportunity Title (or general organization promotion):

Question Title

* 4. Contact person:

Name:

Title:

Email:

Phone:

Mailing address:

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* 5. Additional Contacts:

Name 1:

Title 1:

Phone 1:

Email 1:

Name 2:

Title 2:

Phone 2:

Email 2:

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* 6. Opportunity website(s):

URL:

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* 7. Opportunity description:

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* 8. Opportunity specifics:

Location dates:

Participation dates (approximate):

Eligibility restrictions:

Application Deadline:

For prompt confirmation, please inform Fred Abbott, ESA Diversity Programs Coordinator, of your completion of this form at fred@esa.org. You may also attach an image/logo, no larger than 200x200 pixels, for your Ad.