Company Name*:

Address 1*:

Address 2:

City*:

State*:

Zip Code*:

Name*:

Title:

Phone*:

( )

E-mail*:

Name:

Title:

Phone:

( )

E-mail:

* denotes required field.

Please list your preferred week and we will contact you to let you know what dates are available. We recommend restricting dates to Tuesdays, Wednesdays, and Thursdays for optimal turnout.

Please let us know what type food, if any, you would prefer to have offered and your budget. We will handle the ordering and delivery.

Please let us know of any specific information to advertise, such as if you will be offering any prizes or raffles. We will include the information on e-mails, flyers, and advertisements.

Any comments, special accomodations, or specific requests

• On-campus location
• Week-long publicity
• Flexible scheduling
• Setup and food arrangements

E-mail: indrel@hkn.eecs.berkeley.edu

Phone: (510) 642-7346