Name of Project / Venture
Primary Contact Name
Your Phone Number
Your LinkedIn URL
Website - company or other relevant link
Don't worry if you do not have one
You may enroll as an individual or with one or more team members. If you have additional team members, please list their names and emails below.
Please note that these individuals will be required to attend all meetings and participate fully in the program
Are you currently a student, faculty or researcher at a New England university/college?
Please check one
Postdoctoral associate or fellow
What is your department/lab/center?
Who is your PI?
Please consider including this program in your personal development plans though your PI. We encourage notification and discussion with your PI.
One paragraph non-technical description of the technology (3-4 sentences)
Is this technology based on university/college research?
Have you been involved in the research?
Has an invention disclosure been submitted to your institution's Technology Licensing office or equivalent?
Is there IP? In a few sentences describe the IP status and why you think you will have access to use it or why you expect you can get a license for it
Why do you want to participate in this I-Corps program?
What do you hope to learn?
What outcomes do you hope to achieve?
Please describe your participation in any entrepreneurial programs, including competitions, coursework or programs.
Comments? Anything else you would like us to know?
If you have questions, feel free to send a note to
Should be Empty: