Business Plan Competition Registration Form

* Name of Team Leader:
* Phone Number:
Work Number:
Company Name:
Fax:
Cell:
* Email Address:
* Mailing Address:
Address 2:
* City:
* State:
* ZIP:
Names of Team Members:
* NEPACU School Name:
Faculty Advisor:
Name of Business Plan:
* To be pre-qualified for the competition, please describe the technology component of your business plan: