Apply| Emerging Entrepreneurs Academy

APPLY

Before filling out the application please confirm you can commit to attend all 6 weeks.

Verify that you have reliable transportation to attend workshops, internships, and other events. Status of each applicant will be provided after Jan 31st.

2024 ACADEMY DATES

BERKS COUNTY: June 10 - August 2

APPLICATION

STUDENT APPLICATION

First Name*

Last Name*

Preferred Name/Nickname*

How to Pronounce Your Name (optional)

School District*

Email Address (not school)*

Home Address - Street*

City*

State*

Zip Code*

County*

Cell Phone (optional)

Date of Birth*

T-Shirt Size (unisex)*

Do you have dependable transportation?*

Do you have family members who are entrepreneurs (own a business)?

Why are you interested in the Emerging Entrepreneur Academy (short answer)? *

RECOMMENDED BY: Name*

Recommended by: Email*

Recommended by: Phone*

SCHOOL Type*

Grade completed by June 2024*

PARENT/LEGAL GUARDIAN First Name*

Parent/Legal Guardian Last Name*

Parent/Legal Guardian (Cell) Phone*

Parent/Legal Guardian Email Address*

Parent/Legal Guardian Relationship*

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CONTACT US

Emerging Entrepreneurs Academy

484-333-3270

grseibert@eeainpa.org

2609 Keiser Blvd.

Wyomissing, PA 19610

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