Why do we ask for your Social Security Number?

In the event that your PFEW company wins top honors for the week, PFEW will purchase shares of stock in an international company. Your Social Security number is needed for that transaction.

PFEW does not share your Social Security Number with anyone for any reason other than for the purchase of that stock.
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Company Advisor Sign-up


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

(* Required field)

*Name:
Name on name tag:
Title:
Company:
Address:
City:
State/Province:
Zip/Postal Code:
County:
*Phone: ( )  -
Fax #: ( )  -
*Email:


Who should we contact to thank for your participation?
Name:
Title:
Company:
Address:
City:
State:
Zip/Postal Code:
County:
Phone: ( )  -
Fax #: ( )  -
Email:


Which week do you wish to attend? (Select in order of preference)

*Week 1: July 7 - 14, 2012 - Lycoming College
*Week 2: July 14 - 21, 2012 - Lycoming College
*Week 3: July 28 - August 4, 2012 -
   Lycoming College
*Week 4: August 4 - 11, 2012 - Penn College

How many years have you served as a company advisor? years. (Include 2012)

*What is you shirt size (polo shirt)?
S M L XL XXL XXXL

New Company Advisors:
If this is your first time as a Company Advisor, you will be provided a PFEW polo shirt from our existing stock. Colors will be limited and do not include the options available if you choose to order and pay for your own shirt. If you prefer to purchase your own, you can do so by clicking here.

Returning Company Advisors:
All Volunteers can now purchase their own polo shirt by filling out the CA Shirt Order Form.  If you choose not to purchase a shirt, please be sure to bring a PFEW polo shirt that you received from one of your previous years of service.

*Which training session do you plan on attending?
Unable to attend any session
May 25 (Erie)
June 1 (King of Prussia)

*What are your lodging plans?
I will make a reservation at the Holiday Inn.
I want to stay on campus.
I live locally and do not need other accommodations.

*Would you be willing to serve as a speaker?
Yes   No

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)