Permission Form (online) to Use the Personal Financial Wellness (PFW) Scale

Permission Form (online) to Use the Personal Financial Wellness Scale™ (PFW Scale™)
Please fill in the lines below and press the "submit" button at the bottom. A signed permission will be mailed to you.

* optional fields

Name of person making request:

Job Title:

Affiliation:

Street address:

City:

State:

Zip Code:

Telephone/Fax:

E-mail:

* Website:

Please select which form needed:

Planned use (please describe):

I hereby agree to adhere to the policies cited on the PFEEF website regarding usage of the Personal Financial Wellness Scale™ and understand that use of the PFW Scale™ is not approved until (1) I receive written notification from PFEEF approving my intended use and (2) I have submitted any fees that may apply to my use of the PFW Scale™


(Signature [Person requesting permission signs here])	(Date)

I hereby give approval to the person above to use the Personal Financial Wellness Scale™ for the uses described above.


(Signature [PFEEF staff will sign here and return to user])	(Date)