MAKER MULTIPLIER Employer Application

MAKER MULTIPLIER Employer Application
First Name*
Last Name*
Email*
example@example.com
Cell Phone Number*
Please enter a valid phone number.
Job Title*
LinkedIn Profile URL
Employer Information
Employer*
Street Address*
City*
State*
5-Digit Zip Code*
Industry*

AerospaceAutomotiveConsumer Product GoodsElectricalEnergyFood/BeverageMedical/BioscienceOther
Do you have any prior experience as a company, or personally, interacting as a mentor or ambassador representing manufacturing in Education settings? If Yes, please explain.
E.g., Hosting site tours, MFG Day/Month activities, speaking at schools, etc.
If you already know the employees you would like to recommend for this program, please provide their name(s) and role(s). We will discuss further on a follow-up call.
If known, school district or area of CT you would like your company to be involved with
Next Steps
What is the best way to connect?*

Microsoft TeamsZoomPhoneOther
What is the best time of day to connect?*

9 a.m. to 11 a.m.11 a.m. to 1 p.m.1 p.m. to 3 p.m.3 p.m. to 5 p.m.Other
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Employer Information