Employer Fascimile Registration

CENTRAL PENNSYLVANIA COLLEGE CAREER CENTER REGISTRATION FORM

Please complete this form and then use your browser's PRINT key to develop a faxable copy. Fax this page to the number listed below.

Employer Information:

Business Name:
Address:
City:		State:
Zip Code:		County:
Web Site (URL):
Company's Product or Service

Contact Person:

First Name: Last Name:

Telephone: Fax:

E-Mail:

Use your browser PRINT key to print a faxable form.

FAX This Form To: (717) 732-5254
For Assistance, Please Call (717) 728-2262 0R (800) 759-2727