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NSF I-Corps Hub: Mid-Atlantic Region Mentor Interest Form
The Mid-Atlantic I-Corps Hub seeks to provide a diverse network of mentors to support very early stage I-Corps teams. Mentors get the opportunity to plug in to our regional entrepreneurship ecosystem and give back to the teams looking to learn and innovate.
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* Indicates required question
Your First Name
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Your answer
Your Last Name
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Your answer
Email Address
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Your answer
LinkedIn Profile Link
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Your answer
Check the boxes below if you have significant experience in the following areas: (check all that apply)
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Entrepreneur (on founding team of a startup)
Business Executive
Investment
STEM Research
Technology Startup
Mentoring/coaching
Lean Startup
I-Corps
Required
Choose the primary industries you have experience in (Please choose no more than your top 3)
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Agriculture; Aquaculture
Arts; Media; Entertainment
Banking; Insurance; Finance
Biotechnology; Medical Devices
Communications; Telecommunication
Construction; Real Estate
Community & Economic Development
Education; Youth
Energy; Sustainability; Environmental
Food; Drink; Hospitality
Government; Defense; and Aerospace
Healthcare; Life Sciences
Infrastructure; Utilities; and Mining
Manufacturing; Advanced Materials; Chemicals
Nanotechnology
Nonprofit; Social Impact
Recreation, Fitness, Tourism
Technology; IT; Cybersecurity
Transportation; Wholesale; Logistics
Other:
Required
Optional: Do you identify yourself as any of the following (Please select all that apply; Note that we collect this information intentionally to help foster an inclusive entrepreneurship ecosystem):
African American, Afro-Carribean, or of African Descent
American Indian or Alaskan Native
East Asian or Asian
Non Hispanic White or European
LatinX or Hispanic
Middle Eastern or North African
Native Hawaiian or Other Pacific Islander
South Asian or Indian
Female
Male
Non-Binary
Other:
Please indicate if you have an affiliation with the following university/institutions?
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Bowie State University
Carnegie Melon University
Coppin State University
Pennsylvania State University
Howard University
John's Hopkins University
Morgan State University
North Carolina State University
University of Baltimore
University of Maryland, College Park
University of Maryland Baltimore County
University of North Carolina, Chapel Hill
University of Pennsylvania
Virginia Polytechnic Institute and State University
George Washington University
University of Maryland, Baltimore
TEDCO
Other:
Required
Which entrepreneurs/researchers are you most interested in helping?
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Only those from my university
Those from my state
Any from across the Mid-Atlantic
Provide a brief overview of your background/experience with business, startups, lean-startup, or I-Corps and why you think you this would make you a good mentor:
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Your answer
Why would you like to be a part of the Mid-Atlantic I-Corps Hub mentor network ?
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Your answer
How would you like to support the entrepreneurs and commercializing researchers in the program? (i.e. through mentor meetings, sitting in on the program, being matched with an entrepreneur, or teaching)
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Your answer
Please review The Mid-Atlantic I-Corps Hub's
Mentor Guide
and in lieu of a signature select from the following two options
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Yes, I have read and understand the Mentor Guide
No, I have not read and do not understand the Mentor Guide
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