Entrepreneur in Residence Form
The information that you provide will help us create an experience that is in line with your interests and requests, and connect you with the entrepreneurs that could benefit most from your skills.
First Name *
Your answer
Last Name *
Your answer
Email *
Your answer
Phone *
Your answer
Please tell us why you'd like to be an EIR
Your answer
Please describe your professional background
Your answer
Please identify your areas of expertise
Check all that apply
Please identify areas of industry experience
Check all that apply
Where are you located?
Your answer
Are you willing to complete a short follow-up questionnaire after speaking with a WBC client? *
Required
Do you give the Women's Business Center at CEI permission to include your feedback or testimonial(s) in marketing or communications material for the EIR program? *
Required
I agree to adhere to a general non-solicitation policy while engaging with WBC clients *
Required
I understand that any information shared by or about a WBC client is confidential and cannot be shared without the explicit permission of the WBC and the client *
Required
Please describe your prior experience as a mentor, business advisor or counselor
*You may also include experience as an instructor, coach, teacher
Your answer
What tools, resources or training would make you feel more prepared when meeting with a client?
Your answer
Is there anything else you'd like us to consider when reviewing the information on this form or connecting you with a client?
Your answer
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