2017 Food + Ag Entrepreneurship Academy Application
February 6-8, 2017 @ UC Davis

The academy is a three-day immersive program integrating lecture, exercises, and individual projects. Participants work to identify, design, and validate new business opportunities for their research. Sessions are taught by venture capitalists, angel investors, entrepreneurs and industry executives.

Scholarships available - please indicate interest below.

First Name
Your answer
Last Name
Your answer
Gender
Email
Your answer
Phone
Your answer
Address 1
Your answer
Address 2
Your answer
City
Your answer
State
Your answer
Zip Code
Your answer
Country
(if not from the US)
Your answer
University
Your answer
Department
Your answer
Degrees Completed
Include institution, major / area of study, and date
Your answer
Please check the boxes that best apply to you.
Required
In non-technical terms briefly describe your area of research.
20 words or less
Your answer
List Faculty Mentor and University
Faculty do not need to complete
Your answer
Faculty Mentor's Email
Your answer
Describe (in 150 words or less) a technology or innovation you would like to bring to the program and its potential for commercialization and/or business development.
This technology need not be a part of your own research.
Your answer
Team Application
If applying to AgEA as a team please list your other members.
Your answer
Dietary Restrictions
Please inform us of any special needs (vegetarian, vegan, allergies, etc.)
Your answer
How did you hear about this program?
Your answer
Please indicate if you are affiliated with one of the following programs:
Due to financial need, I would like more information on scholarship availability.
Registration Fees - $250: In-state university/college students and faculty. $500: Out-of-state university/college students and faculty. $1,500: No university affiliation.
Submit
Never submit passwords through Google Forms.
This form was created inside of UC Davis. Report Abuse - Terms of Service - Additional Terms