Registration

ENTREPRENEURS TRAINING PROGRAM REGISTRATION & COMMITMENT FORM

Company Name or Student Name:

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Student's Age:

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Student's DOB:

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Student's Gender:

Male

Female

Office Phone:

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Home Phone:

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Fax:

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Cell:

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Email Address:

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Student's Name of School (If applicable):

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Student's Grade (If applicable):

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YOUR PERSONAL INTERESTS How did you hear about us:

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If you heard from our organization, please answer the following: Name of the person or organization:

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Address and contact information of person or organization:

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Have you completed the YETP before?

Yes

If yes, how many times have you completed the program

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Would you like to start your own business?

Yes

If so, what type of business would it be?

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If you were to actually start a business, what type of obstacles do you think you would face?

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What do you think you would like most about being your own boss?

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What are some goals you have for your business?

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What subjects are you strong in?

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What subject area do you need help in?

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What is the one word that describes you best?

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What hobbies or interests do you have?

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COMMITMENT OF STUDENTS I want to participate in the Young Entrepreneurs Training Program I agree to participate in the training from beginning to end

Yes

I agree to take good care of myself:

Yes

I agree to help my peers, along with other students in maintaining the program:

Yes

I agree to work as a team member, respect and try to be sensitive to the needs of each participant:

Yes

Agreed to this day:

Name

Date:

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Submit registration and we will reserve a place for you in our Entrepreneurs Training Program (YETP). Complete all portions of the registration form. Once this form is received, your reservation in the program will be confirmed. Registration for these programs is on a first come, first serve basis.

10% DISCOUNT FOR EARLY REGISTRATIONS. SCHEDULE BASED ON YOUR AVAILABILITY

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Or call: (516) 739-5101