New Mentor Application GVMS Mentor Application Name * Address * City State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip * Email Address * Phone Number * Age * 25-29 30-40 41-50 51-60 60 and above Race * Hispanic or Latino Black or African American White Native Hawaiian or Other Pacific Islander Asian Other Gender * Female Male Other What industries have you worked in? * (The more detailed you can give, the better!) What are the last 5 business roles you've held? Please list below. What's your employment status * Retired Semi-Retired Working Full-time Working Part-time Are you an entrepreneur? * Yes No If you answered yes to the previous question, what is/was your entrepreneurial activity? In this upcoming year (2017-2018), are there any months in which you are completely unavailable? Are you an expert in a specific subject matter (i.e. law, medicine, engineering)? What are your top 5 skills? Are you able to commit to mentoring at least 8 hours per month? Yes No Are you interested in being a leader of a mentor team? Yes No The following is a list of entrepreneurial activities. If an entrepreneur needed help today, which five activities would you feel most able and comfortable in assisting with? Team Formation Staff Development Digital Media Marketing Founders/Employee Ownership Issues Licensing and Patents Evaluation/Strategy Creating Business Models Review of Financials Visioning Marketing Funding Strategy Presentation Strategy Fundraising Pitch Product Pitch Investment/Financing Sources Communications IT Manufacturing Pharmaceuticals Medical Devices Bioscience/Life Science Foods (Restaurant, Grocery) Social Entrepreneurship B2B Marketing and Sales Strategy Development Bootstrapping Small Business Accounting Legal Intellectual Property How did you hear about GatewayVMS? Submit