EmailMe Form - I-Corps PR Cohort XI: Team Application Form

EmailMeForm

Project Name *
Full Name *
Email *
Phone *
### - ### - ####
Organizational Affiliation (if applicable)
(e.g. University including Campus, Company, Organization, etc.)
Do you commit to participate in all on-line cohort activities?

a. Kick-Off: September 25, 26 & 27
b. Weekly Meeting #1: October 3
c. Weekly Meeting #2: October 10
d. Conclusion: October 24 & 25 *
A full calendar of virtual group activities and individual working time will be provided upon program admittance.
How did you hear about I-Corps PR? *
Is your team fluent in English (reading, writing, listening, and speaking)?
Not at all
Somewhat
Fully fluent
I-Corps PR Cohort XI activities will be fully conducted in English.
Tell us about your project!
What is the concept or idea you are developing? Why? *
What do you think is unique about your project? *
Tell us about your team!
How many team members do you currently have in your group?

1 person teams are not eligible to participate *
2-3
4-6
more than 6
A team of up to 4 (3 team members + mentor) may participate in the cohort.
Who's on your team? (Enter N/A if not applicable) *

Name Direct Telephone Email Profession Organizational Affiliation Will they participate in I-Corps PR Cohort XI?

Team member 1

Team member 2

Team member 3
Why your team? Why now? *
Does at least 50% of the ownership of the business concept submitted belong to someone who resides, works, or attends school in Puerto Rico? *
Do you have a mentor?

A successful entrepreneur, corporate executive, investor, service provider, or academic professional who is choosing to play an active role in the development of your startup by providing advice and wisdom through their past experiences. *
Yes
No
Please note that you don't need a mentor to qualify for the program. If you don't have a mentor, we will assign you one from our mentor pool.
If you do have a mentor, please complete the information below.

Name Telephone Email Profession How did you meet?

Mentor
Is your mentor available to participate in virtual cohort sessions and activities?
Yes
No
Final Questions
Why do you want to participate in the program? *
What will you do if no one wants your initial idea? *
Sustainability Track
I-Corps Cohort XI will feature a special Sustainability Track for teams whose idea targets one or more of the Sustainable Development Goals listed below.

If you think your business idea qualifies for this track, please complete the questions below.
Are you interested in being considered for the Sustainability Track? *
Yes
No
Which Sustainable Development Goal(s) does your idea address? Select all that apply.
Alleviate Poverty
Good Health & Well-being
Gender Equality
Affordable & Clean Energy
Industry Innovation & Infrastructure
Sustainable Cities & Communities
Climate Action
Life on Land
Peace, Justice & Strong Institutions
Zero Hunger
Quality Education
Clean Water & Sanitation
Decent Work & Economic Growth
Reduced Inequality
Responsible Consumption & Production
Life Below Water
Partnership for Goals
Please explain how your business idea promotes the Sustainable Development Goal(s) selected above.
To learn more about the UN's Sustainable Development Goals, visit: https://www.un.org/sustainabledevelopment/sustainable-development-goals/

	Name	Direct Telephone	Email	Profession	Organizational Affiliation	Will they participate in I-Corps PR Cohort XI?
Team member 1
Team member 2
Team member 3

	Name	Telephone	Email	Profession	How did you meet?
Mentor

Tell us about your project!

Tell us about your team!

Final Questions

Sustainability Track