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Puksta "Take a Scholar to Work Day" Sign-Up Form
What is your name?
First Name
Last Name
What is your email address?
Email Address
What is your best telephone number?
Telephone Number
What is your preferred method of involvement.
Meeting with a Puksta Scholar to discuss your industry with them? (Zoom or in person)
Hosting a “Bring a Scholar to Work” day
Both
For the “Bring a Scholar to Work” day, please indicate preferred months:
January
February
March
April
May
June
July
August
September
October
November
December
What is your Job Title
Organization/Company Name:
Industry/Field:
Briefly describe your profession.
What are the majors that would be best suited to exploring a profession in your industry?
Please leave any additional information that you would like us to know in the space provided below.
Can we add you to our newsletter list to keep you updated with the happenings of the Puksta Foundation?
Yes
No Thank You
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