Innovate Springfield Program Application | iSPI Start-Up Map
Please take a moment to fill out our application as thoroughly and thoughtfully as you can. We will respond no later than one week before the first session of the program. All information gathered in this form is strictly for internal use and will not be shared with outside parties.
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Email *
First Name *
Last Name *
Are you an Innovate Springfield member? *
What is your mailing address?
*
What is your phone number? *
Gender *
What is your age?
*
What is your Race or Ethnicity?
*
Do you have a physical or mental impairment which substantially limits you in one or more major life activity; or have a record of having such an impairment; or are regarded as having such an impairment? (to ensure that we are able to provide reasonable accommodations during the course of this program, we will follow up with you at the email you provided if you answer "yes")
*
Highest level of education completed
*
Are you a UIS student or UIS graduate? *
Are you UIS faculty or staff? *
Have you ever served in the military?
*
Business Name (if you have one) *
Business Website (if you have one)
*
Tell us a little about your venture. 
(What will it be? Who will be your customer? What are you selling?)
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What are you hoping to get out of this program?
(Help with marketing? Raising capital? Peers to bounce ideas off of? Accountability? These and more are all great answers!)
*
How did you hear about this program?
*
Thank you!
We will review your application and contact you with a decision soon!
A copy of your responses will be emailed to the address you provided.
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