Social Workers' Network - Agency Registration Form

Name of agency(Required)

Location of agency(Required)

Brief description of agency(Required)

Agency website

What is your agency looking to speak to students on?(Required)

Employment opportunities

Professional development opportunities

Main Point of Contact Name(Required)

First Last

Main Point of Contact Email(Required)

Enter Email Confirm Email

Main Point of Contact Phone(Required)

Emails of other representatives that should be included in communication on the event:

Agency Set Up:

Tables will comfortably accommodate 2 representatives each, but more chairs can be added if necessary. We ask that you please let us know in advance if you intend to have more than 2 representatives in attendance. Agency set up may begin at 11:30 am, with the expectation that your table is ready to go by 11:50 am.
Parking:

One parking space per agency will be available at the Hartford Club parking garage. Any additional vehicles will need to utilize metered street parking or the nearby parking garages.
Food:

Unfortunately, we are not able to provide lunch at this event and ask that you please plan accordingly.
Cancellations:

If your agency no longer can attend, please email sswstudentservices@uconn.edu to let us know as soon as you are able.

Please check the box below to confirm you have read and understand the above event details prior to submitting this form.(Required)

I confirm that I have read and understand the event details.

Name

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