Scientist to Entrepreneur Program

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Discovery Bootcamp Registration Form

Email *

Name Surname *

Phone Number *

What is your level of education and field of study? *

Research Institution *

Research Field *

Position/Title *

Do you currently have any intellectual property (IP) (e.g., patents, copyrights, trademarks) related to your research? *

Yes

If yes, please provide a brief description of your IP and its current status.

Please provide a brief description of your research and its commercialization potential. *

Do you have any teammates or collaborators working on this research with you? *

Yes

If yes, please provide their names and contact info.

Do you have any entrepreneurial experience? *

Yes

If yes, please provide a brief description (venture type, industry, team etc.)

Would you consider forming a company after participating in the Scientist to Entrepreneur Discovery Bootcamp? *

Yes

Would you be open to teaming up with fellow scientists/researchers to form a company? *

Yes

Maybe

Please describe your expectations from the Scientist to Entrepreneur Discovery Bootcamp? *

We will select several projects to be used by teams during the bootcamp. Would you like to propose an idea for team discussion? If so, please provide a short paragraph that summarizes the idea/concept/proposition. Do not include any confidential information” If selected for use in the bootcamp, we will contact you for more information.

How did you hear about us? *

Send me a copy of my responses.

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