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PFEW Speaker Sign-up

Complete the application. We will contact you with more information. Thanks again for your support.

(* Required field)

*Name:
Title:
Company:
*Address:
*City:
*State/Province:
*Zip/Postal Code:
*Phone: ( -
Fax #: ( -
*Email:

Please indicate which weeks you are available to speak:
*Week 1: July 4 - 6, 2017 - Lycoming College
*Week 2: July 11 - 13, 2017 - Lycoming College
*Week 3: July 25 - 27, 2017 -   Lycoming College
*Week 4: August 1 - 3, 2017 - Lycoming or Penn College

Comments On Availability

Potential Speaking Topics

GENERAL RELEASE FOR USE OF PICTURES AND QUOTATIONS

I hereby consent to the publication and use by PFEW of my name, biographical data, quotations or written or verbal statements about PFEW, and any official photographs taken by the PFEW staff for publicity and promotion of the PFEW program. Further, I give permission for my picture to appear on a PFEW Web Page and promotional video. (Pictures and names for the web page will only be used for promotional purposes and are simply snapshots that are taken during the program. No other identifying information will be published.)

By typing my full name below, I am agreeing to the terms above and understand that this “electronic signature” is binding as would be a handwritten signature.


*(type your full name)


*(date)
Validation Code Please enter the validation word that you see in the picture.   
 




Contact Information:

Foundation for Free Enterprise Education
3076 W. 12th St.
Erie, PA 16505

Phone: (814) 833-9576
Fax: (814) 833-9850
info@pfew.org - General Questions
Amber@pfew.org - Student or School Questions
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