NSF I-CORPS APPLICATION | John Pappajohn Entrepreneurial Center

Project Name

What is your team or startup name?

Provide a brief description of your technology or idea. (No scientific jargon).

What commercial problem/opportunity are you seeking to address?

What would you like to gain from this experience?

Does your technology or idea have a website? If yes, please put the link below.

TEAM LEAD INFORMATION

First Name of Team Lead (Founder)

This is usually the individual that has come up with the idea.

Last Name of Team Lead (Founder)

Founder's Role/Title

Example: Entrepreneurial leader, CEO, CFO, researcher.

Team Lead Email Address

Team Lead Phone Number

Team Lead University Department

Team Lead Mailing Address

How many additional team members do you have?

List any additional team members with name and email address.

How did you hear about I-Corps Innovation Workshop?

Media Release

BY TYPING MY NAME IN THE FIELD BELOW, I AGREE THAT I AM AT LEAST 18 YEARS OF AGE, AND THAT I HAVE READ, UNDERSTOOD, AND GIVEN PERMISSION FOR THE USE OF MY LIKENESS OUTLINED HERE: I hereby provide permission for the University of Iowa and John Pappajohn Entrepreneurial Center to use, reproduce, electronically publish, and display my name and company name, photograph, and any information provided by me in all media including, but not limited to, newspapers, magazines, television, radio, and internet websites for the purpose of promoting the John Pappajohn Entrepreneurial Center and the University of Iowa. I understand that this media will be accessible throughout the world and that stories may be in written, video, and electronic form.

By digitally signing this application, you attest that you and your team will fully commit to launching and growing this company and fully engage in the workshop curriculum and activities.