Application Form

Before starting, please study the form and the information required to complete it. You may wish to prepare your essays in advance and paste them into the appropriate fields.



Reference 2 Email:
 
First Name: 
Middle Name: 
Last Name: 
Title: 
Organization: 
Department: 
Address1: 
Address2: 
City:
State: 
Zip: 
Email: 

Applicant is:
An undergraduate student
A graduate student
A resident
A fellow
A post-doc
A practicing physician
A professor
In industry
In a start-up
Other:   
 
Reference 1 Email:
Reference 3 Email:
Curriculum Vitae
Please upload a document with not more than the first 10 pages of your CV.
 

 
Reference 1 Phone:

Completed Degree(s):
Please list completed degrees, specifying the degree, field of study, date/month completed and conferring institution:
 
 
If you chose industry, please specify:
 
 
Reference 2 Phone:


References
Your references should be able to speak to your entrepreneurial potential and experiences, and describe your innovative and intellectual ability and your integrity, including communication and interpersonal skills.

Reference 1 Name:

Reference 3 Name:

Reference 2 Name:


Essay Section
1. Briefly describe your business idea/scientific innovation and the associated business model. Be sure to keep your description non-confidential. For example, do not disclose potentially patentable information about your research. (up to 500 words)
 
 
Reference 3 Phone:
2. Please describe what you see as the biggest challenges to commercialize your idea as it relates to the technology or approach.
 
 
5. When do you plan working full-time on your venture if not already?
 

General Terms and Conditions

1. This Call for Applications ("CfA") is not and shall not be construed to be a contract, offer, or request for an offer. The Kauffman Foundation will have no express or implied obligations or responsibilities to those who apply and will not otherwise be bound by any other terms or conditions, except to the extent set forth in a definitive, final, written agreement duly executed by the Foundation and the award recipient(s). There is no commitment by the Foundation that such a final agreement will be executed, even if the Foundation enters into negotiations with an applicant(s).

2. The Kauffman Foundation in its sole and exclusive discretion may reject any or all applications with or without notice or reasons, withdraw this CfA at any time before or after delivery of submissions, or if no application is accepted, abandon the call for applications.

3. The Kauffman Foundation further reserves the right in its sole and exclusive discretion to waive irregularities or defects in any submission, but in no event will the Foundation have any obligation to do so. Moreover, the Foundation will not be responsible for errors or omissions by anyone making a submission, and the Foundation shall be the sole judge of the responsiveness, appropriateness and completeness of any and all submissions.

4. The Kauffman Foundation reserves the sole and exclusive right in its discretion to modify the timeline for decision-making or otherwise modify or amend this CfA as it deems appropriate.

5. Please do not include any confidential or proprietary information in your response to this CfA. All responses will become the property of the Kauffman Foundation. Regardless of any markings identifying the submission or its content as proprietary or confidential, the Kauffman Foundation reserves the right to disclose or use any information contained in the submissions and other presentations responsive to this CfA.

6. The Kauffman Foundation is not responsible for and will not reimburse any costs incurred in submitting materials or information pursuant to this CfA.

7. The Kauffman Foundation reserves the right to request additional information from any or all applicants and advisors. Applicants and advisors agree to make themselves available for follow-up as reasonably requested by the Foundation.

 
4. What needs you have in terms of knowledge/education to successfully execute on your vision?
 
 
3. Please list activities including types of people you have engaged to further develop your ideas. This could include blog memberships, business competitions, fundraising, investigation of licensing rights, potential customer discussions, etc. (up to 500 words)