2018-19 Startup Scholars Registration

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Please complete by March 1st.

Name *

School *

Grade *

email address *

Parent email address *

Mobile or Contact # (mobile preferred) *

Do you have an idea? *

Yes

Maybe

Are you part of a team? *

Yes

Maybe

Other:

If yes and your team members want to attend as well, please list their names.

Have you participated in other entrepreneurship programs or competitions? (select all that apply)

Yes, a SQUARE1 Program

Yes, KY LGEC

Yes, other

Company or Product Name *

If you have an business idea, please provide a brief description.

Are you be interested in a internship opportunity with a startup and small business? *

Yes

Maybe

Are you or a member of your group interested in continuing the work on your idea or working with other startups with SQUARE1 over the Summer? *

Yes

Maybe

Another group member is interested (insert name and email on the next line - "other".

Other:

Required

Please list any time constraints you may have for the March 14th Semi-Final at Gateway running from 4-7PM.

I certify that I asked my other group members about their interest int he internships and summer work. *

Yes

Submit

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