Employer Registration Form

Birmingham Employs Neurodiversity Featured Employer Registration
Thank you for choosing to participate in the Birmingham Employs Neurodiversity Expo on November 19 (9am-12pm, Regions Field).

Participating exhibitors are encouraged to attend a keynote luncheon prior to the event on November 18 (11am-1pm, Regions Field).

Please complete the following form to complete your registration.

Please note: We have capped this event at 150 students, ages 16-22. Each participating student has been recommended by a faculty representative at their current school, confirming their ability to pursue internship opportunities.
Company Name*
Representative 1 Name*

First NameLast Name
Representative 1 E-mail*
example@example.com
Representative 2 Name

First NameLast Name
Representative 2 E-mail
example@example.com
Representative 3 Name

First NameLast Name
Representative 3 E-mail
example@example.com
Representative 4 Name

First NameLast Name
Representative 4 E-mail
example@example.com
Phone Number*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please RSVP for the Employer's Keynote Luncheon on November 18, 11am-1pm:*

Yes, 1 representative will attendYes, 2 representatives will attendYes, 3 representatives will attendYes, 4 representatives will attendUnfortunately, no representatives are available to attend the November 18 luncheon. My team will attend the expo on November 19.
I agree to participating in post-event surveys:*

YesNo
The primary purpose of this initiative is to take action in furthering workplace neurodiversity, following the expo. Each employer is encouraged to offer internships to 1-2 students, averaging 4-6 hours / week for the 2025 Spring or Summer semester. Will your workplace participate in this way? (Students will still have to apply according to your organization's hiring process and be selected)*

YesNo, we will only exhibit at the event to share with students about our industryI would like some assistance with compiling a description of an internship to offer
If applicable, how many job openings does your company currently have?*
Please upload your company's logo for inclusion in event collateral:*

Cancelof
My company's exhibit will require the use of an outlet:*

YesNo
A Note Regarding Booth Set Up:

There are 2 opportunities to set-up your booth: Between 9:30am-11am on November 18 (to be followed by the Employer's Keynote Luncheon at 11am) or November 19 from 7:30-9:00am. Tables and chairs will be provided for your booth. If providing applications for internships / job openings, please have printed information available on how to apply. We also welcome displaying merchandise for learners' swag bags. Questions may be sent to Kristen Jackson at kjackson@springvalleyschool.org.
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Birmingham Employs Neurodiversity Featured Employer Registration

A Note Regarding Booth Set Up: