Jonas Weil Entrepreneur Fellowship Fund Application
First Name
Last Name
Email
Cornell Net ID
MBA Program
Two-Year MBA
One-Year MBA
Dual MBA
Graduation Year
Applicant Status
New Applicant
Renewal Applicant
Company Name
Please select all that apply to you:
See program description Section II for eligibility requirements
.
Start my own business
I have founder's stock in the startup
Work for a startup with stock or stock-options in lieu of salary
Startup provides principal form of employment and source of income
Are you the company's founder or co-founder?
Founder
Co-founder
NA
Title
What is your role at the startup?
Description of the business
1-2 sentences
Year the business was incorporated
Current business plan or pitch deck which shows the business' current state and future plans:
Please upload the document as a PDF
Corporate Legal Documents
Please attach documentation to show the formation of the corporate entity and its current good standing, such as a certificate of incorporation.
Employer Identification Number (EIN)
If you are not the President / CEO of the business, statements from from the President of the business and/or Corporate Counsel addressing the nature of employment and the form of compensation
Evidence of the holding of shares in the business
For example, a current cap table, founders agreement, or other document that shows your shareholding as a percentage of the total shares.
Number of months you’ve been employed by the business
Please answer this question if this is a renewal application.
Company Address - City
Company Address - State
Company Address - Zip Code
What is the total amount of student loan payments you are proposing the Fellowship would cover this year?
The fellowship covers the cost of loans associated with obtaining a Johnson education (see program description).
If I am approved to receive funding, I understand that I am subject to the terms as described in the program description, and agree to submit an annual report (each January) to the Johnson Entrepreneurship Track describing the state of my entrepreneurial venture and involvement in it, including metrics on startup growth that include (but are not limited to) statistics such as jobs created, capital raised, and revenue earned, etc.
Yes
No
Contact Information