Sustainable Entrepreneurship and Innovation Initiative INCUBATOR MENTOR REGISTRATION Kogod is passionate about the power of entrepreneurship to change lives; build sustainable new business, nonprofit and social ventures; create economic opportunities; link purpose and profit; and make a difference. The Kogod School Incubator is an integral component of the Sustainable Entrepreneurship and Innovation Initiative and a student’s entrepreneurial educational experience. Students complete a Proof of Idea Proposal, are interviewed and, if admitted to the Incubator, transition from “learning” about entrepreneurship to “living” entrepreneurship in a supportive environment as they move forward to transition their passion and their idea into reality. Please complete and return this Incubator Mentor Registration to: elab@american.edu along with a copy of your CV or bio. You will be contacted concerning the next steps and to schedule a follow up phone conversation. ******************************************************************************** Date: 1. Contact information: Name Email Cell phone number Company Name Title Preferred mailing address AU Alum—please indicate school/year/major 2. What areas do you think you could make the greatest contribution based on your expertise and experiences? 1 3. Would you prefer to mentor an entrepreneurial business venture team or a social/nonprofit venture team? Please check one box only. Prefer an entrepreneurial business venture team ……… Prefer a social/nonprofit venture team …………………. Either one is OK …………………………………………... ! GO TO Question 4 ! GO TO Question 5 ! ANSWER Both Questions 4 & 5 4. Identify top 3 key industries YOU would be most interested in being a Mentor to a business student venture team (be relatively specific). 1. ___________________________________________________________________ 2. ___________________________________________________________________ 3. ___________________________________________________________________ 5. Identify top 3 key nonprofit sectors YOU would be most interested in being a Mentor to a student venture team (be relatively specific). 1. ___________________________________________________________________ 2. ___________________________________________________________________ 3. ___________________________________________________________________ 6. Do you have previous mentoring or coaching experience with new profit, nonprofit or social ventures? If so, please describe. 7. What are you looking forward to in your potential role as an eLAB Incubator Mentor? 8. Please provide a summary of your skills and experiences to supplement your resume. Please attach a copy of your CV American University is a tobacco and smoke free campus. Applications are considered without regard to race, ethnicity, gender, sexual orientation, age, religion, nationality, disability, socioeconomic standing, and intellectual viewpoint. 2