Teacher Recruitment Day

Registration Form

Registration fee:  $75 ( Includes resumes, refreshments, and luncheon).

$35 for each additional person

 Office of Placement Services,
1000 ASU Drive 540,
Alcorn State, MS  39096-7500
*please check one : Dr. Mr. Mrs. Ms.
*NAME :           
  first name                    middle initial    last name
*TITLE :
   
*SCHOOL :
*ADDRESS1 :
ADDRESS2 :
   
*CITY :    *STATE :        *ZIP :
   
TELEPHONE :                     E-MAIL :
   

FAX NUMBER :

I will participate

I will not participate

Mail the check  made payable to the ASU Office of Placement Services

 Will pay fee on site

Need an electric outlet

Special Dietary Needs

Comments :

List the additional person's coming with you! Separated with a comma( , )