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echallenge - Entrepreneurs' Challenge

Further Enquiries:
Entrepreneurship, Commercialisation and Innovation Centre (ecic)
Level 1, Engineering South Building
THE UNIVERSITY OF ADELAIDE
SA 5005 AUSTRALIA
Email

Telephone: +61 8 8303 7422
Facsimile: +61 8 8303 7512
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Team Registration Form

Team registrations are due by 12pm Thursday 13th August.

To register your team please either fill out the online form below or print a hard copy of the registration form and fax it to the echallenge office on 8303 7512.

1. Team/Business Name
Team/Business Name *
2. Brief description of Concept Proposal/Business Plan
Brief description of Concept Proposal/Business Plan*:
By completing this section, a Team agrees that the brief description should be made available for disclosure to the media and general public in connection with echallenge

3. Agreement to Terms and Conditions of Entry
In submitting this registration form, each Team Member:

  • has read, understood and agrees to be bound by the Terms and Conditions of Entry to the University of Adelaide Entrepeneurs' Challenge (echallenge).
  • understands that the best efforts will be used by the University of Adelaide to ensure the confidentiality of submissions from Teams including Concept Proposals, Business Plans, and other information arising in the course of the competition and agrees to release the echallenge Organising Committee, Judges, Mentors and Sponsors from any further liabilities, responsibilities and accountabilities arising from or in relation to the echallenge.
Team Member 1

Name *:

Email address *:
Acceptance *: I accept the terms and conditions of entry
I do not accept the terms and conditions of entry
Team Member 2

Name:

Email address:
Acceptance: I accept the terms and conditions of entry
I do not accept the terms and conditions of entry
Team Member 3

Name:

Email address:
Acceptance: I accept the terms and conditions of entry
I do not accept the terms and conditions of entry
Team Member 4

Name:

Email address:
Acceptance: I accept the terms and conditions of entry
I do not accept the terms and conditions of entry
Team Member 5

Name:

Email address:
Acceptance: I accept the terms and conditions of entry
I do not accept the terms and conditions of entry

Team Member 6

Name:

Email address:
Acceptance: I accept the terms and conditions of entry
I do not accept the terms and conditions of entry

4. Student Member and Primary Contact Details

Each Team is required to have at least one currently enrolled student member. Please indicate the details of one Team member who meets this criterion. This student will also act as the Primary Contact Person for your Team and will be the person with whom the Organising Committee will correspond on all metters relevant to the echallenge. (Where there is more than one student, nominate one in this section.)
Name *:
Student Number *:
Program in which enrolled *:
Postal address *:
Email address *:
Phone *:
Mobile *:
Fax *:
5. Request for a Mentor
Subject to part 3 of the Terms and Conditions, would you like to work with a mentor if one is available to you? *

Yes
No

If yes, what sort of skills would you wish your mentor to bring to your team
What are your expectations of the mentoring process?
6. Additional student team members
Are you looking for more student team members? * Yes
No
If yes, from what area of the University would you wish to source these team members?
* = required fields

Copyright © 2009 The University of Adelaide
Last Modified 08/11/2009 Entrepreneurs' Challenge
CRICOS Provider Number 00123M

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