AUntrepreneur Application

To help us decide if the AUntrepreneur program is a good fit for you, please take the time to fill out the information below.

Applicant's First Name

Applicant's Last Name

Name of person completing form (if different than applicant)

Email of applicant (or person completing form if different)

Do you have an idea for a service or product you would like to sell?

Yes

Not Sure

Tell us about your special interests or what you are passionate about. This can include any ideas for business products or services you might have.

List your strengths- skills, abilities, talents (If unsure, state "I don't know").

Specify highest level of education

List any work, volunteer, apprenticeship experience

What are your biggest concerns about your future and your ability to reach your career goals?

List any learning strategies, accomodations or supports that you need or have been helpful in the past

List current diagnosis

Thanks for submitting! We will be in touch with you soon.