Entrepreneurial Foundation of American Application

FOUNDATION BENEFITS:

By Joining The Entrepreneurial Foundation, You Will Receive:
- Exclusive Membership
- Eligibility For Entrepreneur Of The Year Award
- A Reduced Price On Admission To Future Events
- Discounts On Available Products
Annual Fee: $50

*Please note that membership dues are not deductible as a charitable contribution. A porton of your dues may be deducted as an ordinary business expense for federal tax purposes.
Please Answer All Questions & Provide Requested Information. Incomplete Applications Will Not Be Processed.
Name*
First Last
Preferred Nickname/Badge
Date Of Birth*
MM slash DD slash YYYY
Social Security Number*
Organization*
Job Title*
Job Description*
Mailing Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Home Number*
Mobile Number*
Fax Number
Email Address*
Preferred Method Of Contact*
Send Entrepreneurial Mail To*
Telephone Preference*
Have You Ever Been Convicted Of A Felony?*
Name Of Member Who Referred You To Entrepreneurial Foundation Of America
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone Number
Are You A High School Graduate?*
ACADEMIC HISTORY - College 1:
School:
Year Graduated:
City & State:
Dates Attended:
Degree Earned:
Major:
Minor:
Certification(s):
Award(s):
ACADEMIC HISTORY - College 2:
School:
Year Graduated:
City & State:
Dates Attended:
Degree Earned:
Major:
Minor:
Certification(s):
Award(s):
ENTREPRENEUR QUESTIONS:
Please List All Awards Or Honors Received:
Please State Why You Should Be Accepted Into The Entrepreneurial Foundation Of America?*
If Accepted, Do You Already Have An Idea For A Business You Would Like To Pursue?*
What Entrepreneur Do You Admire The Most And Why?*
If Accepted, What Are The Top 3 things You Would Most Like To Learn?*
I hereby make application for membership in the Entrepreneurial Foundation of America and pledge, if accepted, to abide by the membership requirements of the association as they are now in effect, and as they may be amended. Applicant acknowledges that the use of the association logo is exclusive to members only an applicant agrees to cease utilizing the logo upon termination of membership.*
- I Agree
Electronic Signature*

Please electronically sign this application by placing your initials in-between two slash symbols. For example: /ABC/
Signed By:*

Please type your full legal name.
Date*
MM slash DD slash YYYY
Annual Fee:
Price:
Must be renewed annually.
Total
$0.00
Payment Information
New Payment Section
Name on Card*
First Last
Card Number*

Card Number
Expiration Date*

Expiration Date
Security Code*

Security Code
Bank Name*

Bank Name
Name on Account*

Name on Account
Bank Routing Number*

Bank Routing Number
Bank Account Number*

Bank Account Number
Credit Card*

American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
Billing Address*
Street Address Address Line 2 City State ZIP Code
Total
$0.00
- I agree to receiving marketing and promotional materials.

FOUNDATION BENEFITS:

Please Answer All Questions & Provide Requested Information. Incomplete Applications Will Not Be Processed.

ACADEMIC HISTORY - College 1:

ACADEMIC HISTORY - College 2:

ENTREPRENEUR QUESTIONS:

Payment Information

New Payment Section