Hub Mentorship Form
Thank you for your interest in the I-Corps
TM
Hub West Mentorship Program. Please fill out this form and we will reach out to you with next steps.
First Name
Last Name
Preferred Name
Email
Industry
Sub-Industry
Area(s) of Expertise
Communications
Design Thinking
Education
Engineering
Finance
Fundraising
Human Resources
Information Technology
Law
Marketing
Operations
Procurement
Product Development
Product Management
Project Management
Quality Assurance
Risk Management
Software Development
Sales
Strategy
Have you participated in I-Corps Hub West programming in the past?
Yes
No
Have you participated in a National I-Corps cohort in the past?
Yes
No
If yes, in which role did you serve for the National I-Corps cohort?
Please select...
Entrepreneurial Lead
Technical Lead
Industry Mentor
Principal Investigator
Have you founded or worked in a startup in the past?
Yes
No
If yes, in what way did you participate in the startup?
Please select...
Founder
Advisor
Investor
Employee
Other
How did you hear about the I-Corps Hub West Mentorship Program?
Please select...
Newsletter
NSF Referral
Faculty Referral
Student Referral
I-Corps Hub West Website
Other website
Please specify
Contact Information