Student Registration Form
PEN America’s Free Expression Student Summit at the University of Tennessee-Knoxville

Dinner and Panel
Friday, March 31, 2023 | 4:00pm - 6:00pm
Student Union 169

Workshop Series (Breakfast and Lunch Provided)
Saturday, April 1, 2023 | 10:00am - 3:30pm
FBCC

Registration is open to students at the University of Tennessee-Knoxville to attend one or both days. The deadline for students to register has been EXTENDED! If you have any questions please contact Crystal Hardeman-Ikem, Associate Dean of Students, at chardema@utk.edu.

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Email *
First Name *
Last Name *
Date of Birth *
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Which days do you plan on attending? (Select all that apply) *
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Current Academic Year:
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School(s), College(s), Programs(s) (Please select all that apply) *
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Gender Identity
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Race/Ethnicity (Please select all that apply)
Do you have any accessibility requirements?
Do you have any food allergies, or dietary restrictions?
Would you like to opt-in to regular email updates from PEN America about opportunities for students including job openings, fellowships, essay competitions, and certification institutes? *
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PEN America would like to take photos and videos of our Free Expression Student Summit from March 31-April 1 to share online on our websites and social media accounts. We'd greatly appreciate if you could please read and accept the Media Release Waiver below so that we can share and promote similar opportunities to students at UTK and on other campuses:

"I authorize PEN America to photograph, film, broadcast, record or otherwise document and edit my image, likeness, and voice in connection with the Program (“Free Expression Student Summit at the University of Tennessee-Knoxville, Spring 2023”). I grant to PEN America and its successors, assignees and licensees the right to use photos and recordings from the program or any part thereof, for, but not limited to, broadcasting, merchandising, advertising, promoting and marketing of PEN America and its activities and for educational purposes via radio, television, video, the internet, podcasts, publications (print and digital) or by any other means now known or hereafter devised. I waive any right to royalties or other compensation arising from or related to the use of the photos and recordings."

Please accept by signing electronically below:
A copy of your responses will be emailed to the address you provided.
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