First Name *

Last Name *

Business/Organization Name *

Your Title

Email Address *

Phone Number *

Street Address of Business/Organization *

City *

Zip Code *

Please describe the work of your business or organization.

How would you like to be involved with the MiSTEM Network's Greater West Michigan Region? (Check all that apply) *
Mentor a student
Student internships
Job shadow opportunity
Apprenticeships
Student/Teacher business or industry tours
Teacher externship
STEM events (career fairs, family STEM nights)
Employee volunteering/other in-kind support
Speaking engagements/keynote speaker (at a conference or in the classroom)
Donate materials and/or equipment
Financial resources - funds, grants, or sponsorships
In-kind space donation (for MiSTEM or other regional events)
Not listed Please specify a value for How would you like to be involved with the MiSTEM Network's Greater West Michigan Region? (Check all that apply)

Please include any ideas or information you would like to share with us.