Application – EFC 2024

Thank you for your interest in the Entrepreneurial Fellows Program from the Institute for Entrepreneurial Excellence. Complete the form below as your application to join the 2024 class.

"*" indicates required fields

Applicant First Name*

Applicant Last Name*

Title*

Organization*

Email*

Cell Phone*

Mobile Phone*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

What is your company's primary business?*

Website*

Name of Owner/President/CEO*

Year Founded*

Please enter a number from 1700 to 2023.

NAICS Code*

# of Employees*

Annual Revenue (approx.)*

Annual Sales Growth in last 12 mos. (%)

Graduated College?*

Yes

College/University

Degree

Application Information and Fees

All information is strictly confidential and will be used for class selection purposes.
Only one company per industry is selected. Potential for class synergy is used in the selection process. Class size is limited.
All inclusive fee of $5,500 is due upon acceptance (minus discounts, if applicable).

Attendance Policy
Your participation in the monthly meetings is crucial to the success of the program. Attendance is mandatory; you are only permitted to miss a maximum of two classes. Graduation certificates cannot be issued to those who have missed more than two classes. In the case that you cannot attend a session, please notify us as soon as possible. There are no substitutes permitted in the event you are unable to attend class.

Financial Responsibility

Deposit Payment
To secure your slot in the class, you are required to pay a deposit of $500 via PayPal within 7 days of receipt of welcome email upon acceptance. Upon receipt of your deposit, you will receive a confirmation email with the complete details regarding your EFC schedule and invoice for remaining tuition balance. If you do not pay your deposit within the 7 days, you spot will be forfeited to be filled by another applicant.
Tuition Balance
Upon receipt of the invoice, you will have net 30 day to pay the remaining balance of your tuition. Should your payment be delayed beyond the first session you will no longer be able to attend future sessions until your payment tuition payment is received in full.

Signature*

Completion and signature on this application indicates you have read and agreed to the attendance requirements and financial responsibilities as described above.

Date

MM slash DD slash YYYY

If accepted, I am fully committed to attending all sessions and coming prepared to embark on a voyage of lifelong learning that will result in the success of my business for generations to come.*

Yes

How did you hear about EFC 2024?*

Flyer/Brochure

Email Promotion

IEE Website

Facebook

Newspaper/Magazine Ad

Referral/Word-of-Mouth

In-Person Event

Name

First Last

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Institute for Entrepreneurial Excellence|3520 Forbes Ave. Pittsburgh, PA 15261

Application – EFC 2024

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