[Print this form to mail and register your school's "authorized agent" with the NMEA JOBS BULLETIN service.]

Name of "authorized agent"__________________________________________________________

Position_________________________________________________________________________

Name of School___________________________________________________________________

Address_________________________________________________________________________

City______________________________________________ State______ Zip_________________

Phone____________________________________ County________________________________

NMEA/NSAA Region or District (if known) 1, 2, 3, 4, 5, 6 ________________

E-mail:______________________________________________________

*School World Wide Web address (URL)_______________________________________________

Mail to:

NMEA Jobs Bulletin
Joyce Patch, Executive Director
539 North 6th St
Broken Bow, NE 68822-1313

*Filling in the WWW address (URL) will automatically give NMEA permission to link to your school's Web site.