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: Click here to enter text. Occupation: Click here to enter text. Education history (Please include all academic and professional qualifications and relevant trainings.) Click here to enter text. Employment history: Click here to enter text. 1 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? Click here to enter text. When did you start thinking about developing your idea/ project? Click here to enter text. Who are your target customers and which are your target markets? Click here to enter text. Who are your competitors and how is the level of competition? Click here to enter text. What is your business model? Click here to enter text. How will be your business idea/project develops over the next five years? Click here to enter text. 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? Click here to enter text. What is your business’s annual turnover? Click here to enter text. How much funding did you already receive? Click here to enter text. What would you like to achieve attending the impulse programme? Click here to enter text. 2 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.) Click here to enter text. 3 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 4
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