Innovation Challenge: Intent to Compete Form Submission

Required Fields - *

I have read and agree to terms and conditions. *

The team leader must complete the following information.

Team name: *

Password: *

Retype Password: *

In two to three sentences, please describe your business idea:

Faculty Advisor

Name:

School/Department:

Email Address:

Team Leader

First Name:

Last Name:

Email Address:

Student ID #:

Are you a full-time student at the University of Massachusetts Amherst?* Yes No

If yes, what school are you enrolled in?

If yes, what is your expected degree date? (MM/DD/YYYY)

If yes, what is your expected degree?

If no, did you graduate from UMass Amherst after February 2004? * Yes No

If yes, what was your degree and major?

If yes, what was your date of graduation? (MM/DD/YYYY)

Team Members

Are you looking for additional team members? Yes No

If yes, how many team members?

If yes, please briefly describe the skills and background that you desire in teammates:

List Team Members

Name:                                             Affiliation: