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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Your First Name *
Your Last Name *
Email Address *
LinkedIn Profile Link *
Check the boxes below if you have significant experience in the following areas: (check all that apply) *
Required
Choose the primary industries you have experience in  (Please choose no more than your top 3) *
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):
Please indicate if you have an affiliation with the following university/institutions? *
Required
Which entrepreneurs/researchers are you most interested in helping? *
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: *
Why would you like to be a part of the Mid-Atlantic I-Corps Hub mentor network ? *
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) *
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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