STOMP CY Pilot Programme Application Form

Please complete the fields below to be considered for the STOMP CY pilot programme. Please submit your application by June 12, 2019. All applications will be reviewed by the CyprusInno and CSI teams. Those selected to participate in the programme will be notified and sent a terms of participation form, release form, and parental consent form. All forms must be signed for participation. Should you have any questions, please feel free to reach out to us at info@cyprusinno.com. Best of luck and we look forward to meeting you! :)

Email address *

First Name *

Last Name *

Age *

City of Residence *

Phone Number (if applicable)

Do you know what entrepreneurship is? *

Yes

Sort of

Are you interested in entrepreneurship or in launching your own business? *

Yes

I don't know yet

Why do you want to be a part of this programme? *

Are you available on June 15 from 10AM - 5PM? *

Yes

Will you require transportation to and from Nicosia? *

Yes

Other:

This event may require crossing to the south side or north side. Do you have any issues crossing the checkpoint? *

Yes

Other:

Have you ever met someone from the other community before? (From Turkish Cypriot community or Greek Cypriot Community) *

Yes

Please rate your level of proficiency in English *

Poor

Excellent

What school do you attend? *

What school year are you in? *

Please list the full name and contact information (email and phone number) of a parent below *

You understand that a Terms of Participation form, a Release Form, and a Parental Consent Form must be signed before acceptance to this programme *

Yes

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This form was created inside of CyprusInno.