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Contact information
EIR Application Form
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Email
*
Your email
Please confirm your email
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Your answer
The EIR rotation involves a commitment of 10-15 hours per month. Check below to confirm your understanding of this:
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Yes, I understand and agree to the commitment
No, I do not agree to the commitment
Required
First and Last Name
*
Your answer
Mailing address (Street address)
Your answer
Mailing address (City, zip)
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Your answer
How did you find out about this program ? (please be specific - this helps us figure out what works)
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Word of mouth Friend/peer
Social media friend/peer
Faculty referral/recommendation
University Social media
University/faculty email
Other:
Required
Phone number (xxx-xxx-xxxx)
Your answer
List your College. Example: College of Business and Technology
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Clemmer College of Education
College of Arts and Sciences
College of Business and Technology
College of Clinical and Rehabilitative Health Sciences
College of Nursing
College of Public Health
Gatton College of Pharmacy
Honors College
Quillen College of Medicine
College of Graduate and Continuing Studies
Other:
List your Department/Major and Concentration/Minor (if undeclared, put undeclared). Example: Management, Fashion
Your answer
Select your current college level
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Sophomore
Junior
Senior
Graduate/Post-Graduate
Faculty
Required
Is there a startup of interest to you or do you have a startup concept in mind? If so, what is it? (If none, put none or n/a)
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Your answer
List of prior Entrepreneurship/VC classes/program/bootcamps completed. (If none, put none or n/a)
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Your answer
Industry/topics of interest. For example: Outdoor Recreation (if none, put none or n/a)
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Your answer
If selected into this program, what would a successful experience look like for you?
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Your answer
Send me a copy of my responses.
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