Innovation & Entrepreneurship Engagement Opportunity Questionnaire
Personal Information
First Name
Last Name
Email
Phone
City of Residence
State of Residence
Please select...
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District Of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Puerto Rico
Virgin Island
Northern Mariana Islands
Guam
American Samoa
Palau
Company Name
LinkedIn Profile
What academic degrees do you have?
PhD
MBA
MD
MS
MA
MPH
BSBA
JD
Other
If Other, please specify below:
Are you a UNC Chapel Hill alum?
Yes
No
What year did you graduate from UNC?
What was your major while attending UNC?
We are collaborating on alumni engagement with a group of UNC departments, schools, and programs. Are you interested in working with one of the following groups in particular, or are you looking to engage more broadly with innovation at UNC?
Department of Computer Science
Kenan-Flagler Business School
Shuford Program in Entrepreneurship
Interested in engaging more broadly
Did you participate in any of the following entrepreneurship curriculum tracks at UNC?
Adams Apprenticeship
BSBA (KFBS undergraduate)
Carolina E(I) Lab
Graduate Certificate in Technology Commercialization & Entrepreneurship
MBA (KFBS) strategy & entrepreneurship concentration
School of Education MA in Educational Innovation, Technology, & Entrepreneurship (MEITE)
Shuford Program in Entrepreneurship (undergraduate minor)
Startup-UNC (KFBS/CES) - was Launch the Venture
Other
None
If Other, please write the program name below:
Role Questions
What role are you interested in?
Mentoring a Student or Faculty
Guest Lecturer in a Class
Judging a Competition
Being a Host Site for Interns
Joining a Startup
Providing Office Hours
Do you have details about your internship's job description at this time?
Yes
No
Are you interested in investing in startups?
Yes
No
Thank you for your interest! We will be in touch soon to discuss investment opportunities.
How will you contribute to our entrepreneurial community? Would you prefer working with students, faculty, or no preference?
What is your area of expertise?
Accounting
Business Strategy/Development
CFO/Controller
Financial Advising
Fundraising and Investment
Graphic Design/Video/Animation
Human Resources
Legal
Marketing
Recruitment
Sales
Sustainability
Technology
Website Design
Other
Other Area of Expertise
Company Website URL
Please briefly tell us about your relevant background.
Please briefly provide more information about the types of services you offer.
What UNC innovation and entrepreneurship programs are you interested in working with?
1789 Venture Lab
Adams Apprenticeship
BeAM (Be A Maker)
Blackstone Entrepreneurs Network
Campus Y / CUBE Social Innovation Initiative
Carolina Angel Network
Carolina Challenge Business Venture Competition
Carolina E(I) Lab
Center for Health Innovation
Chancellor's Faculty Entrepreneurship Workshop
Eshelman Institute for Innovation
Gillings School of Global Public Health
Global Entrepreneurship Week
KFBS Center for Entrepreneurial Studies
KickStart Venture Services
LAUNCH Chapel Hill Accelerator
MEITE Program (School of Education)
Shuford Program in Entrepreneurship
StartUp-UNC (Formerly Launching the Venture)
Other
Other Program of Interest
Did someone refer you?
When would you like to start getting involved?
What is the time frame that you will be available?
Do you have any questions or comments?
Upload your CV or resume.
Upload a professional headshot. Please upload a photo
no larger than 1MB
in size.
We appreciate your interest in supporting UNC's startups. Upon receipt of this form, we will forward your information to the relevant programs on campus. We will be in touch to learn more about your services and include your information in our database for future opportunities.
Thank you again.
Program Applying To verification
Innovate Carolina Mentor Program
Startup Experience
What is your current role at your company?
Please give us a brief summary of your work history.
How many startups have you started?
How many of your startups are still active?
Please tell us more about your startup history. If one or more of your startups is no longer active, what was their exit strategy (M&A, IPO, liquidation, etc.)?
Investor Experience
Are you an accredited investor?
Yes
No
Describe your experience as an Angel investor.
Describe your role as a general partner in an investor fund.
If you have made individual investments in a startup or other types of private investment, tell us more about your experience.
Intern Site Questions
Company Information
Company Website
Company Location
Timing of Internship
Spring Semester
Summer
Fall Semester
Do you have specific start and end dates?
Yes
No
Start Date
End Date
Industry
Please select...
Life Sciences
Software and Information Technology
Consulting or Other Services
Agriculture and Horticulture
Engineering and Physical Sciences
Other
Other
Company Description
Internship Job Description
Deadline for application
Email to Apply to Internship
Application Instructions
Would this be a paid experience?
Yes
No
Would your ideal intern be full or part time?
Full Time
Part Time
Flexible - would be willing to talk to qualified candidate interested in full or part time
Would you like us to post this internship on our website?
Yes
No
Will you have this internship listed on your website?
Yes
No
Please provide the URL to the page where the internship will be posted:
Contact Information
Innovation & Entrepreneurship Engagement Opportunity Questionnaire
Innovation & Entrepreneurship Engagement Opportunity Questionnaire