Hub Entrepreneurs Club Application
So you are an entrepreneur and you want to build your network, get additional support, and be part of a community of like-minded innovators? Impact Hub's Hub Entrepreneurs Club could be the place to for you! Please complete this application form to let us know that you are interested in joining our community and why. We will review your application and let you know if you are successful. There is no fee to joining Hub Entrepreneurs Club, but you do need to be committed to business, committed to making a positive impact in Cambodia, and agree to participate in the activities and support available to you.

If you have any questions please contact Abi at abigail.perriman@impacthub.net and she'll be happy to help!

Email address *
Phone number *
Your answer
Given Name *
Your answer
Family Name *
Your answer
Gender *
Date of birth *
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Which province are you from? *
Your answer
Which university did you attend? *
If you did not attend a university please write "None"
Your answer
About your business
Name of Startup *
Your answer
What stage is your business at? *
Describe your business idea *
Your answer
What are your main challenges? *
Required
Explain in details these challenges and what support you expect from Impact Hub: *
Your answer
About Hub Entrepreneurs Club
How did you hear about Impact Hub? *
If you heard about us from a friend, who was it?
Your answer
Why do you want to be a member of Impact Hub's Hub Entrepreneurs Club? *
How do you think Impact Hub can help with the development of your enterprise? What services offered by Impact Hub are you interested in accessing?
Your answer
Which of the following services would you like to access as a member of Impact Hub? You can choose as many as you like. *
Required
As a member of the Hub Entrepreneurs Club we require that you agree to the following, please tick the box if you agree: *
Required
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