Request edit access
Brinc Scout Application Form
Thank you for your interest in joining the Brinc Scout Family!

As a Brinc Scout, you’ll get exclusive access to our programs, events, networking opportunities, and performance rewards while helping us discover the next generation of startups.
Sign in to Google to save your progress. Learn more
First Name *
Last Name *
Preferred communication channel
 *
Required
Please provide your contact above  *
What best describes your current role?
 *
Required
Which industries do you have the strongest connections in?
 *
Required
Where are you primarily based?
 *
Required
Acknowledgement 
 *
·         I acknowledge Brinc’s privacy policy (https://brinc.io/privacy-policy) as set out in the attached link on how Brinc will protect and process my data.
·         I acknowledge that I am not, and will not be after registration as an employee of Brinc.
·         I agree to keep confidential all information I receive from Brinc (including information concerning program participants) and if requested, I will return or destroy any confidential information that is in my possession.
Required
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Brinc.

Does this form look suspicious? Report

Google Forms