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Register an Education Program or Event
Complete and submit this form to add your program or event to the PFBC's web calendar.
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* Required fields
# Data entered in field will be included with the web calendar listing (if yes is selected for "May we post on PFBC web site?")
PROGRAM * #
  I'm a SMART Angler   Ladies Introduction to Fly-Fishing
  Family Fishing Program   Introduction to Kayak Fishing
  Family Ice Fishing Program   Kids Fishing Derbies / Rodeos
  Introduction to Fly-Fishing   Introduction to Fishing Activity
        Other Program or Event
          For Other Programs or Events ONLY - Specify:
          Name of program or event#
           
          Description of program or event#
INSTRUCTOR INFORMATION
First name
Last name
 
Instructor number
 
Instructor Customer Identification Number (CID) (found on fishing license)
Daytime telephone (xxx-xxx-xxxx)
E-mail address*
 
Address
City
State
Zip code
PROGRAM INFORMATION
Date (mm-dd-yyyy)*#
Park, lake or site*#
County*#
Start time#       Stop time#
a.m.
p.m.
   
a.m.
p.m.

Program location (e.g.; boat house, beach, etc.)#

Street address (nearest if none)#
City#
Zip code#
Sponsor
Web site address for more information#
(include http:// or https://) (leave blank if none)

NOTE: Want to apply for an educational exemption to the fishing license requirement? Then click here for the application for fishing license educational exemption form. Click here for more information on this exemption. Complete this form and follow instructions for submitting. Please allow four weeks for processing. You may include multiple programs and/or dates on a single application.

REGISTRATION INFORMATION
Open to the Public?   Yes
    No
Pre-registration required?#   Yes
    No
 
Contact name for registration#
Registration contact telephone (xxx-xxx-xxxx)#
Extension#
Registration contact email address#
 
Website address to register (include http:// or https://) (leave blank if none)#
WEB POSTING INFORMATION
May we post on PFBC website?*   Yes   No

A confirmation message will be sent to the instructor email address provided.
After submitting this form you will be taken to the PFBC home page.