Workplace Exploration 2013

Thank you for your interest in participating as a host in the June 2013 "Workplace Exploration" program. Please complete the requested information and we will follow up with you as details of the program are finalized.

Emily Neuendorf, Chamber Director
Fred Ribich, Chair, Waverly Area Education Roundtable

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* Please enter your contact information.

Name:

Company:

Address:

Address 2:

City/Town:

Email Address:

Phone Number:

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* Please check the dates and time blocks (exact times for visits to be determined) that will work for your organization to host a 90 minute session for a group of school personnel.

	Morning (8:30 - 11:30 block)	Afternoon (1:00 - 4:00 block)
Tuesday, June 4	Tuesday, June 4 Morning (8:30 - 11:30 block)	Tuesday, June 4 Afternoon (1:00 - 4:00 block)
Wednesday, June 5	Wednesday, June 5 Morning (8:30 - 11:30 block)	Wednesday, June 5 Afternoon (1:00 - 4:00 block)

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* Feel free to add any comments or suggestions you have regarding this program.

Thank you for this information. We will follow up as soon as program details are developed.

Click on the "Done & Submit" button below to register your responses.