The 2013 Experiential Classroom (September 26-29, 2013)

Name

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Address

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Email*

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Do you currently teach at a university, college, or other institution?

Yes
No

What institution?

Do you plan to be teaching at a university, college, or other institution in the future?

Yes
No

At what Institution?

Have you previously taught a course in entrepreneurship?

Yes
No

Please list the names and number of times of the course(s) you have taught:

Please briefly explain any professional background you have with starting, running, financing, or advising entrepreneurial ventures.

Please briefly describe your highest level of academic achievement, including the major or field you studied.

Why do you want to attend the Experiential Classroom? Provide a brief explanation.

Tell us something unique about yourself.

Have you attended SEE or any of the other LLEEP clinics?

Yes
No

Please indicate which program and what year.

Are you currently a member of the United States Association for Small Business and Entrepreneurship (USASBE) (please note that this is not a requirement for acceptance to the Experiential Classroom)?

Yes
No

Are you applying for one of our Riata/USASBE Scholarships to cover part of the costs of enrollment?

Yes
No

Please briefly indicate why you require this assistance.

Phone

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Experiential Classroom

Riata Center

The 2013 Experiential Classroom (September 26-29, 2013)

The Experiential Classroom