CAREER READINESS DAY PARTICIPATION FORM GRADUATE AND PROFESSIONAL SCHOOLS COMPANIES/CORPORATIONS AND ORGANIZATIONS FRIDAY, FEBRUARY 23, 2024 | 10:00 am - 11:45 am The UNCF National Alumni Council/National Pre-Alumni Council Leadership Conference provides an array of opportunities for graduate and professional schools to recruit some of the best students into graduate programs or professional job opportunities. REGISTRATION INCLUDES: 6’x 30” table, two chairs Listing in Legacy Gala program book Lunch ticket(s) for 2 representatives Fees are non-refundable. SESSION 1: 10:00 am - Noon. Field Is Required Register: $500.00 College/Univ, Governmental Agencies $1,000.00 Non-profit Organizations $2,500.00 Corporations Additional Amount Billing Information Name of Organization Title: Miss Mrs. Ms. Mr. Mr. and Mrs. Admiral Ambassador Apostle Archbishop Assemblyman Bishop Brigadier Brother Canon Cantor Capt. Cardinal Chancellor Chaplin Cmdr. Cmsgt. Col. Commodore Congressman Congresswoman Councilman Deacon Delegate Dr. Dr. and Mrs. Drs. Elder Evangelist Father First Lieutenant First Sergeant Fr. Friar General Gov. Governor Grand Matron GYSGT (Ret) Hon. Judge Lieutenant Commander Lieutenant Governor Lt. Lt. Colonel Lt. General Madam Major Major General Master Mayor Messrs. Minister Mother Msgr. Msgt. Overseer Parish Pastor Pastor Elder Ph.D President Private First Class Prof. Professor Prophet Prophetess Rabbi Rector Representative Rev. Rev. Mr. Reverend Canon Reverend Cantor Reverend Dr. Reverend Elder Rt. Reverend Sen. Senior Master Sergeant Sergeant Sergeant Major Sfc. Shepherdess Sir Sir/Madam Sister Spc. Sr. Pastor Staff Sergeant Superintendent Technical Sergeant The Hon. The Honorable The Venerable Vicar Vicar Bishop Required First Name: Middle Name: Last Name: Suffix: , I , II , III , IV , V , Jr. , Sr. Required Street 1: Street 2: City: State/Province: AK - Alaska AL - Alabama AR - Arkansas AZ - Arizona CA - California CO - Colorado CT - Connecticut DC - District of Columbia DE - Delaware FL - Florida GA - Georgia HI - Hawaii IA - Iowa ID - Idaho IL - Illinois IN - Indiana KS - Kansas KY - Kentucky LA - Louisiana MA - Massachusetts MD - Maryland ME - Maine MI - Michigan MN - Minnesota MO - Missouri MS - Mississippi MT - Montana NC - North Carolina ND - North Dakota NE - Nebraska NH - New Hampshire NJ - New Jersey NM - New Mexico NV - Nevada NY - New York OH - Ohio OK - Oklahoma OR - Oregon PA - Pennsylvania RI - Rhode Island SC - South Carolina SD - South Dakota TN - Tennessee TX - Texas UT - Utah VA - Virginia VT - Vermont WA - Washington WI - Wisconsin WV - West Virginia WY - Wyoming AS - American Samoa FM - Federated States of Micronesia GU - Guam MH - Marshall Islands MP - Northern Mariana Islands PR - Puerto Rico PW - Palau VI - Virgin Islands AA - Armed Forces Americas AE - Armed Forces AP - Armed Forces Pacific AB - Alberta BC - British Columbia MB - Manitoba NB - New Brunswick NL - Newfoundland and Labrador NS - Nova Scotia NT - Northwest Territories NU - Nunavut ON - Ontario PE - Prince Edward Island QC - Quebec SK - Saskatchewan YT - Yukon None Required ZIP/Postal Code: Country: United States Afghanistan Aland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivarian Republic of Venezuela Bonaire, Sint Eustatios and Saba Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Cote D'Ivoire Croatia Cuba Curacao Cyprus Czech Republic Democratic People's Republic of Korea The Democratic Republic of the Congo Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Federated States of Micronesia Fiji Finland The Former Yugoslav Republic of Macedonia France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and McDonald Islands Holy See (Vatican City State) Honduras Hong Kong Hungary Iceland India Indonesia Iraq Ireland Islamic Republic of Iran Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Kuwait Kyrgyzstan Laos People's Democratic Republic Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Palestinian Territory, Occupied Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Plurinational State of Bolivia Poland Portugal Puerto Rico Qatar Republic of Korea Republic of Moldova Reunion Romania Russian Federation Rwanda Saint Barthelemy Saint Helena, Ascension and Tristan da Cunha Saint Kitts and Nevis Saint Lucia Saint Martin (French) Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles S. Georgia & S. Sandwich Isls. Sierra Leone Singapore Sint Maarten (Dutch) Slovakia Slovenia Solomon Islands Somalia South Africa South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syrian Arab Republic Taiwan, Province of China Tajikistan Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United Republic of Tanzania Uruguay USA Minor Outlying Islands Uzbekistan Vanuatu Viet Nam Virgin Islands (British) Virgin Islands (USA) Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Required Email Address: Phone: Cell Phone Website Yes, I would like to receive communication from this organization. Remember Me Additional Attendees Additional Attendee Additional Attendee Additional Attendee Additional Attendee Display Needs Electrical Outlet Yes No Type of Display Table Display Floor Display Pop-up Banner Yes No Please select the major in which you are interested Business Behavioral Science Biology Chemistry Computer Science Education Health Care Math This radio option selects the field value from the following text input field. Payment Information Payment Method: Credit Card Credit Card Information: Credit Card Type: Visa Discover American Express MasterCard Required Credit Card Number: Expiration Date:Select month of credit card Select Expiration Year 01 02 03 04 05 06 07 08 09 10 11 12 2024 2025 2026 2027 2028 2029 2030 2031 2032 2033 2034 CVV Number: What is this? Check Information Process