Name of School:
Phone Number:
Primary Contact Person:
Email:
Secondary Contact Person:
Secondary Email:
Number of students in club:
Number of active students in club:
Our school has (select one):
Never participated in MESA Career Day
Participated in the past but was unable to attend last year
Attended last year
Will you be bussing with another school/club?: Yes No
If yes, what school/club will you be sharing a bus with?
The primary contact person listed above will be notified by January 14, 2008as to whether or not your school was selected to attend.