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USM CAREER SERVICES AND PROFESSIONAL LIFE DEVELOPMENT Graduate and Professional School Information Day Registration Form
Will you be participating?
Yes No
Institutional Information
Organization
Program Name
Work Phone
FAX
E-mail
URL
Contact Information
Name
Title
Work Phone
E-mail
Will you need electricity?
Yes No
Representative Information
Name
Title
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Work Phone
FAX
E-mail
Representative Two
Name
Title

    Please give a brief description of your school or program.
  This information may be used on our website for students to view.

When you have completed your registration form, please mail your $150.00 fee made payable to USM Career Services and mailed to:

Univ. of Southern Maine
Atten: Mary Ann Benson
96 Falmouth Street
PO Box 9300
Portland, ME 04104-9300