CERI Entrepreneurial Mindset Bootcamp Application

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Name* This field is required.
First Name
Last Name
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Email* This field is required.
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Phone Number* This field is required.Your best mobile number, in case we need to contact you regarding your application.
Please enter a valid phone number.
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Before you apply, would you prefer a brief discovery call with Kristen, our Program Lead?* This field is required.
Yes - I have a couple of questions
No - I am ready to apply
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Book a time that suits you.
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Please select the Bootcamp dates that you would like to apply for:* This field is required.Day 1 & 2 of the bootcamp will run from 9am-6pm each day. The intro session will take place one week prior, from 4.30pm-6.30pm.
Intro: 03/10/22 Day 1 & 2: 10th + 11th of October
Intro: 14/11/22 Day 1 & 2: 21st + 22nd of November
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Please select the scholarship you would like to be considered for:* This field is required.
Student Scholarship ($110)
Founder's Scholarship ($110)
Part-Time Scholarship ($220)
Full-Time Scholarship ($330)
Mannkal Student Scholarship
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Did someone refer you to CERI?If so, please enter their name here.
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Do you have any Dietary Requirements?Full catering is provided for both days while attending the Bootcamp.
Vegetarian
Vegan
Gluten Free
Kosher
Halal
Tree Nut Allergy
Other
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Are you involved with a university?* This field is required.
Yes
No
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Fill in the following blanks that fit you best:
Currently, I am at * where I am a * in the field of *
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Whether now or going forward, where do you see your university career taking you?* This field is required.
Advanced materials
Advanced manufacturing
AI
BioTechnology
Blockchain
Quantum computing
Robotics
Photonics
Electronics
Green energy
Agriculture
Life sciences
Pharmaceuticals
Health
Well-being
Education
Finance
eCommerce and retail
Technology
Digital Technology
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Do you have your own company or a Start-up you are pursuing?* This field is required.
Yes
No
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Fill in the following blanks that fit your company best:
Hello! Our company is called Company Name * . We have been operating for number of months * months and have a team size of team size * people. So far, we have made around * in total revenue. Currently, the stage we are at is best described as * . Our current biggest problem revolves around * .

You can find more about us here: Website/LinkedIn * .
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Now we have some of the details about your company ironed out, its time to tell us what your company does. Give a brief, elevator-pitch, description below about what you and your company do.* This field is required.
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Does your company fall into some of the categories listed below?* This field is required.
Advanced materials
Advanced manufacturing
AI
BioTechnology
Blockchain
Quantum computing
Robotics
Photonics
Electronics
Green energy
Agriculture
Life sciences
Pharmaceuticals
Health
Well-being
Education
Finance
eCommerce and retail
Technology
Digital Technology
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Do you work for a large organisation where you are tasked with innovation?* This field is required.
Yes
No
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Fill in the following blanks that fit your employment best:
Hello! I work for Company Name * . The project we're working on is called project title * . Currently, the stage we are at is best described as * . Our current biggest problem revolves around * .

You can find more about us here: Website/LinkedIn * .
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Now we have some of those details out of the way, what is it that this project is trying to achieve? Give a brief overview below.* This field is required.
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If you're one of our friends from Mannkal Economic Education Foundation, check below.
I am a Mannkal Scholar.
No, I am not a Mannkal Scholar.
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The last thing we want to cover is the reason why you are applying. In the box below, please give a brief answer to who you are, why you are interested in the program and what you hope to get out of it.* This field is required.
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Persona
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Deep Tech
Should be Empty: