Your Name (required)
---Br.Dr.Fr.MissMr.Mrs.Prof.Sr.

Title:

Phone #:

Your Email (required):

Enter your institution name below

Institution (required):

Graduate/Professional Program (required):

Street Address (required):

City (required):

State (required):
---AKALARAZCACOCTDCDEFLGAHIIAIDILINKSKYLAMAMDMEMIMNMOMSMTNCNDNENHNJNMNVNYOHOKORPARISCSDTNTXUTVAVTWAWIWVWY

Zip Code (required):

Country:

Please check if interested in advertising:
Full PageHalf PageQuarter PageElectronic Billboard

Registration Type: Recruiter

Registration is $250

Advertising Fee: Full Page ($500) Half Page ($250) Quarter Page ($125) Electronic Billboard ($150)

Is this your first meeting at the conference?:
YesNo

Note that lunch vouchers will be provided for recruiters that will be accepted by restaurants on FIU campus.

If you require special accommodations to fully participate, please describe your needs:

Are you from a Baccalaureate College?:
YesNo

Are you from a Comprehensive University?:
YesNo

Are you from a Research University?:
YesNo

Are you from a Two-Year College?:
YesNo

Are you from a Technical College or University?:
YesNo

Are you from somewhere other than the above listed institutions? If so, where?

Payment Information

Please check your payment option
Cashier's CheckMoney Order

Make Cashier’s Check/Money Order to FIU, and mail to:
Allen Varela
Florida International University
The Honors College
11200 SW 8th Street DM 233
Miami, FL 33199

Solve this math problem to complete registration:

1+1=?