The INNOVATION REPOSITORY Registration Form
SEEKING STUDENTS, FACULTY and INDUSTRY EXPERTS

The GOAL of The INNOVATION REPOSITORY: 
To connect Higher Education and Industry who will form an INNOVATION TEAM to support local and cross-regional entrepreneurs who have current innovation challenges in product development, prototyping, technology issues in the development of products. The projects will require help from engineering, IT, manufacturing, science, Technology, Math and Business.
 
Most projects will fall in the industries of: Technology, Agriculture, Renewable Energy, Sustainability, Artificial Intelligence and autonomous flight. 

Opportunity open to entrepreneur projects from:  Shenandoah Valley, Roanoke Valley, New River Valley, South West Virginia, and Southsid
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First Name
Last Name
Email Address
Contact Phone #

PROFILE INFORMATION

Affiliations: If more than One Affiliation is selected Prioritize First Intention=1, Secondary Intention = 2)

I am a: (How would you be engaging with Innovation Repository)

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If you checked Faculty Member, what is the name of the college or university?
If you checked Faculty Member, what is the name of your department or area of expertise?
If you checked Student, what is the name of the college or university?
If you checked Student, what is your major?
If you checked Industry Expert, what is the name of you company?
If you checked Industry Expert, what is industry type or specialty?
If you checked Innovator, what is the name of your business?
If you checked Innovator, what is your business' industry type?
If you checked Innovator, which of the following stages best describes your business?
Clear selection
If you answered other to previous question, please describe your current sage of business.

Timeline for engagement: How long do you prefer being engage in a project ? 

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Engagement Method:   Each project challenge requires varied types of contact. Please state your preference:

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** NOTE: Innovators who want to submit their Innovation Challenge 
You will need to fill out an Innovation Challenge Project Description Form - See website -  https://theadvancementfoundation.org/innovation-repository
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