Application Form doc - Maxwell Centre

Impulse - For Tech Innovators
To apply for the impulse entrepreneurship programme you will need to complete and
submit our application form. Please fill in the boxes below.
Personal Details
Title*: Click here to enter text.
First Name*: Click here to enter text.
Surname*: Click here to enter text.
Address*: Click here to enter text.
City*: Click here to enter text.
Postal Code*: Click here to enter text.
Country: Click here to enter text.
Email*: Click here to enter text.
Telephone number*: Click here to enter text.
Employment status
Organisation address:
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Occupation: Click here to enter text.
Education history
(Please include all academic and professional qualifications and relevant trainings.)
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Employment history:
Click here to enter text.
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Business idea/ project
Please briefly describe your business idea/ project:
Click here to enter a date.
How did you come up with your idea/ project?
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When did you start thinking about developing your idea/ project?
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Who are your target customers and which are your target markets?
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Who are your competitors and how is the level of competition?
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What is your business model?
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How will be your business idea/project develops over the next five years?
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If you have already started a business please answer the following questions:
When did you start your business?
Click here to enter a date.
How many people are in your team?
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What is your business’s annual turnover?
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How much funding did you already receive?
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What would you like to achieve attending the impulse programme?
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Course and accommodation fees
I would like to apply for:
Cambridge University Participant (£ 1,000)
Individual Entrepreneur (£ 1,500)
Non Cambridge University Participant (£ 4,000)
Who is paying for the course?
Yourself
Your employer
Your sponsor
I require accommodation during the course:
Yes. (Accommodation is only on a first come, first serve basis.)
No accommodation required.
Who is paying for the accommodation:
Yourself
Your employer
Your sponsor
No accommodation required
Sponsor information
(Please fill in the contact details for where the invoice should be sent, including a
contact name in the accounts department of your sponsoring institution.)
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For our records
How did you hear about impulse? Click here to enter text.
Data protection statement
The data from this form will be held on our central database and are used for the
impulse programme.
I declare that the information given in connection with this application is correct
and that I have read and accepted impulse's cancellation policy as stated on this
website
If you need further help or would like to comment our application form please get in
contact with [email protected].
We really appreciate your feedback. Many thanks.
Impulse
Maxwell Centre, University of Cambridge
JJ Thomson Avenue, Cambridge, CB3 0HE, UK
Tel: +44 (0)1223 747368
Email: [email protected]
Website: www.maxwell.cam.ac.uk/programmes/impulse
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