Request MI STEM Partnership at Your Event

* Indicates required questions

If you are interested in having the MI STEM Partnership as an exhibitor in your event, please complete the form below and submit it for our consideration.

Name *

First

Last

Job Title *

Company Name *

Email *

Work Phone # *

Mobile Phone #

What is the date of the event? *

Where will the event be held? Please be as specific as possible. *

Event website link: *

Please provide descriptive details about the event. *

What opportunities are we being offered? *

Exhibit table
Exhibit booth
Materials seat drop
Materials table drop
Materials in attendee kit
Speaking (if this option, please go to Speaker Request Form)

Is there a cost involved for us to participate? (If yes, please email pricing details to MiSTEMPartnership2015@gmail.com) *

Yes
No

Enter code in image: