Primary Contact Information
School/Organization
Salutation	Mr. Ms. Mrs. Dr. Lt. Sgt.
Primary Contact First Name
Primary Contact Last Name
Title
Telephone	( )  -    ext
Fax	( )  -
Email
Address
City
State	Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington Washington D.C. West Virginia Wisconsin Wyoming
Zip Code
District/School Information
Website
School Type	Public   Charter    Other:
School Area	Rural Suburban  Urban
Testing Requirements	NTE Praxis State Test   Other:
District/School Description (optional)
Anticipated Vacancy Notice (optional) (Cut and paste your vacancy notice in this section if you wish).

Payment Method
Please indicate below the payment method that you will be using. Please note, after completion of this registration form, the primary contact person will be emailed an invoice. Those wishing to pay online by VISA or Mastercard can click into the secure domain link provided in the email. A mailing address is provided in the invoice for check payments.
Payment Type:	Credit Card (VISA or Mastercard accepted) Check Purchase Order | Number:

Fees and Services Information

OPTION 1: Job Fair Registration and Booth Rental Fees include: 1 six foot table; 2 chairs; signage; continental breakfast, pre-fair publicity via website listing. $250.00 for each booth with one representative $300.00 for each booth with two representatives $350.00 for each booth with three representatives More than one booth or more than three representatives (see below) Please note: If registering for more than one booth or if you plan on having 4 or more recruiters please contact the Site Coordinator, Carolyn Thomas, at cfthomas@uri.edu or at 401.874.5250. Please note that two recruiters fit comfortably at one six-foot booth.

OPTION 2: On-Line Job Posting (for non-attendees). If you are unable to attend, but would like to promote your anticipated jobs, please select the option below and complete the registration form. Your job will be posted online to our students. $100.00 for non-attendees. For additional information contact Linda Ernst, Providence College, 401.865.2184, lernst@providence.edu

Attendee Information
Please indicate school representatives that will be attending. Name tags will be created based on this information. These names will not be visible to students. Indicate "tba" if you are not sure of name at this point, and return to registration form to update information at a later date (link will be provided in email sent to primary contact person).
School Representative (1)	Same as contact person
First Name (1)
Last Name (1)
Title (1)
Email (1)
School Representative (2)	To be announced or unknown
First Name (2)
Last Name (2)
Title (2)
Email (2)
School Representative (3)	To be announced or unknown
First Name (3)
Last Name (3)
Title (3)
Email (3)
School Representative (4)	To be announced or unknown
First Name (4)
Last Name (4)
Title (4)
Email (4)
School Representative (5)	To be announced or unknown
First Name (5)
Last Name (5)
Title (5)
Email (5)
School Representative (6)	To be announced or unknown
First Name (6)
Last Name (6)
Title (6)
Email (6)

School Anticipated Needs

Please indicate the types of candidates that you would like to visit your booth. Candidates view this information online and note schools that are interested in their major. Select "check all" if you do not want to limit who visits your booth. Note: this list reflects the various majors of member school candidates that may be present at the fair.

Deselect All | Check All Secondary Middle Elementary Early Childhood Education Administration Support Professionals   School Counselor   School Psychologist   School Social Worker   Speech/Language Pathologist   School Nurse Teacher Specialists   Art   Dance   Theater   Music   Technology Education   Media Specialist/Librarian   Reading Specialist/Consultant   Health   Physical Education   Home Economics   Vocational Education Subject Areas   Business Education   Elementary Classroom Teacher   English as a Second Language/Bilingual   Special Education   English       Mathematics       History       Social Sciences       Spanish       French       German       Italian       Latin       Portuguese       Chemistry       General Science       Physics       Biology       Other #1   Other #2

After you click to submit your registration form an invoice will be emailed to the Primary Contact Person including a:

• Mailing address for those paying by check
• Link to a secure credit card site for the convenience of those wishing to pay by VISA or MasterCard
• Link to edit your registration form in order to add or change contact information or anticipated vacancies.