Name* First Last Email* Phone Number*Company NameWhat is your availability to connect with a startup at the moment?*I have a good amount of time to devote to helping startups & am looking forward to more connectionsMy time is limited, but I can commit to at least 4 hours per monthI’m very busy & a single event or connection per month is all I can squeeze in right nowAlthough wishing to be involved, I’m currently not able to make any time commitments to help startupsSelect the categories that are most descriptive of the value that a tech startup will find in you.* Founder: I am a founder of one or more tech startups that requires/required outside funding, OR I am the founder of a venture that is/was successful at rapid scaling without investor money Coach: I am actively involved as an investor in a number of tech startups, OR I have been closely involved in investor-funded tech startups, such as being a C-Level leader in one or more startup(s) Subject Matter Expert (SME): I am an expert in a particular area that is of interest to some or many entrepreneurs Domain Expert: I have a deep knowledge of one or more particular market verticals and how to exploit them for startups (i.e. social media, big box retail, computational genomics, etc.) Connector: I have a personal network of decision-makers, investors, industry leaders, etc.; and I am willing to make introductions for viable startups that need those connections Your bio*Tell us more about your value to a tech startup founder also why you want to become a mentor*LinkedIn URLTwitter URLReferralITEN Pro Bono Agreement* I affirm that I offer my advice and expertise to ITEN companies on a pro-bono basis. Any other arrangement with a startup will be by prior agreement with the ITEN Executive Director. ITEN Confidentiality and Conflict of Interest Policies* I accept the terms of ITEN's Confidentiality Policies
