Center for Entrepreneurship & Innovation - Grand Valley State University

2012 Teen Entrepreneur Summer Academy Registration

Please complete the following registration information for the 2012 Teen Entrepreneur Summer Academies in Grand Rapids (June 18-22) and Holland (June 25-29). You will be asked to submit a 200-word essay and $25 payment at the end of this form. A full refund will be awarded after you/your student attends all five days. Please also email or fax one letter of recommendation from a teacher/principle/professional mentor to the Center for Entrepreneurship & Innovation at 616-331-7583 (fax) or cei@gvsu.edu by June 1, 2012 for the Grand Rapids Academy, and June 8 for the Lakeshore Academy.

Demographic Information:

First Name: *
Last Name: *
Address: *
Address 2:
City/Town: *
State: *
Zip Code: *
Date of Birth: * (mm/dd/yyyy)
Email: *
Phone: * (XXX-XXX-XXXX)

Academy Information:

Session Location: *	Grand Rapids (June 18-22) Lakeshore (June 25-29)
School Name (as of Fall 2012): *
Grade Level (as of Fall 2012): *
Adult T-Shirt Size: *

Essay Question:

Please describe how this experience will be beneficial in your future (approx. 200 words). It may be easier to write your response in a word processor and then copy and paste the content into this text box. *

Comments:

Please write any comments below regarding food allergies, contact preferences, etc.

If you have questions, please contact the Center for Entrepreneurship & Innovation at 616-331-7582 (office) or cei@gvsu.edu. Academy details are also available online at http://gvsu.edu/cei/tesa.