Engineering Interest Survey

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	Thank you for your interest in engineering opportunities with the Wisconsin Department of Transportation. Please complete the information below to be on our contact list for future hiring activities.

1.	First Name*

2.	Last Name:*

3.	E-mail address*

4.	Major:

5.

Current college/university (or most recent, if graduated):

	UW-Madison
	UW-Milwaukee
	UW-Platteville
	Marquette
	Michigan Tech

Other, please specify

6.

Current Status in School:

	Freshman
	Sophomore
	Junior
	Senior
	Completed Bachelor Degree
	Graduate Student
	Completed Graduate Degree

7.	Projected Graduation Date:

8.

I am interested in the following types of job opportunities:
Check all that apply.

	Permanent
	Internship

9.	Street Address

10.	City

11.	State

12.	Zip

13.	Daytime Phone:

14.	Evening Phone: