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Advisory Board Application

First name*

Last name*

Email*

Phone*

Address (residence)*

Occupation(s) / Professional title

School (degrees) and specialties*

Why are you interested in this position?*

What particular strengths would you bring to this position?*

Experience and community affiliations*

Recommended by (please add references - name, address, phone, email)

Signature of applicant*

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Date*

Month

Day

Year

Phone : (860) 212 8164

mc2nets@yahoo.com

Mailing Address

MC² Technology, Inc.

P.O. Box 2023

Hartford, CT 06145-2023

© 2026 MC² Technology, Inc.

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