PURDUE COOPERATIVE EXTENSION SERVICE College of Agriculture Dear Future Entrepreneur, Are you ready to create the next great Indiana business? Come join other young entrepreneurs like yourself at the Indiana 4-H Entrepreneurship Academy! Who: Indiana youth currently in high school; in teams of no more than four Space is limited to 30 participants. Indiana 4-H membership is not required. When: June 26-28, 2017 Where: Purdue University, West Lafayette Cost: $190 How: 1. Write a 300-word essay that addresses: Why you want to attend the Entrepreneurship Academy, what you hope to learn by attending, and an example of a time when you've successfully or unsuccessfully worked in a team. Submit this essay with your application. 2. Complete the enclosed application (pages 2-5). 3. Submit the essay, application and registration fee of $190. (All team members must register, complete the essay, and pay the registration fee.) Alternately, you may complete all of these items online at http://bit.ly/in4hentr17 but you will still need to mail the $190 registration fee in order for the application to be complete. We can t wait to see you at the 2017 Indiana 4-H Entrepreneurship Academy! Respectfully, Ryan Wynkoop Special Projects Coordinator Indiana 4-H Youth Development rwynkoop@purdue.edu 765-494-8435 Indiana 4-H Entrepreneurship Academy Indiana 4-H Youth Development Program Agriculture Administration Building 615 W. State St. West Lafayette, IN 47907 (765) 494-8435 FAX: (765) 494-0268 fourh@four-h.purdue.edu www.extension.purdue.edu/4h Purdue University, Indiana Counties and U.S. Department of Agriculture Cooperating An equal access/equal opportunity/affirmative action university
Who: Indiana youth currently in high school Where: Purdue University When: June 26 28, 2017 Why: To create the next great Indiana business! Academy Highlights Register Today Spend 3 days experiencing Purdue University Interact with worldclass faculty and staff Learn about useful business resources June 26 28, 2017 Purdue University $190/participant More details and register: http://bit.ly/in4hentr Register by MAY 15 2017 Questions: Ryan Wynkoop rwynkoop@purdue.edu 765 494 8435 extensiondoes.org
2017 4-H Entrepreneurship Academy Registration Student Information First and last name Address City State Zip Phone E-mail (required) Current Grade Age (as of June 26, 2017) Gender: T-shirt Size (adult sizes only): S M L XL XXL Attendee requires auxiliary aids/services due to disability. Dietary, Allergy, and medical restrictions: (Please list food allergies and known medical restrictions/issues) Medical Information Medical Conditions Current Medications Date of Last Tetanus Shot Physician s Name Physician s Phone Demographic Information This information is only for federal reporting requirements. Your name will not be associated with this information in any reporting and these questions are optional. Are you currently enrolled in Indiana 4-H? (select one) Yes No If yes, please write the county in which you are enrolled: (i.e. Marion, Lake, Vigo, etc.) What is your ethnicity? (select one) Hispanic/Latino Not Hispanic/Latino What is your race? (select ALL that apply) American Indian or Alaska Native Asian or Asian American Black or African American Native Hawaiian or Pacific Islander White Other Please mail this form and payment by May 15, 2017 to: 4-H Entrepreneurship Academy 615 W. State St. West Lafayette, IN 47907 2
2017 4-H Entrepreneurship Academy Registration Parent/Guardian Information First and last name Address City State Zip Phone E-mail (required) Emergency Contact First Contact Name Relationship to Participant Day Phone Night Phone Second Contact Name Relationship to Participant Day Phone Night Phone Registration Fee Include with this application a check payable to Purdue University for $190. The registration fee covers lodging, meals, program supplies, and insurance for the duration of the on-campus event. Please mail this form and payment by May 15, 2017 to: 4-H Entrepreneurship Academy 615 W. State St. West Lafayette, IN 47907 3
2017 4-H Entrepreneurship Academy Registration Team Participants are encouraged to assemble and attend the event as a team of no more than four (a group of friends, classmates, club members, etc.). However, if you can t assemble a team, you can register independently and we will match you with a team. If you have assembled a team, please list your team members' names below. A team can have a maximum of four members (including yourself). Remember that each team member must meet eligibility requirements and register to attend. Spots will be held for your team members but if they do not completely register by May 15, their spot will be forfeited to allow those on the waiting list to attend. Please list your team members below. If you want to attend the academy but do not have a team, simply write "no team" and we will match you with a group. 1. 3. 2. Program Components The 4-H Entrepreneurship Academy has three components: 1. June 26-28, 2017 On-campus experience at Purdue University. This is where you ll experience hands-on entrepreneurship activities, meet a mentor, and begin working on the business pitch. 2. At home (July through September) Independent group work from July-September. This is an opportunity to perfect your pitch. You will have access to a business mentor during this time. 3. October 14, 2017 Final business pitch at Indiana State Fairgrounds to compete for scholarship money. Your team is not required to participate in the final business pitch but you will not be eligible for scholarship money if you do not present your pitch on October 14. Please check the box below indicating you understand the components of the Indiana 4-H Entrepreneurship Academy. Please check this box indicating you have read the program components listed above Please mail this form and payment by May 15, 2017 to: 4-H Entrepreneurship Academy 615 W. State St. West Lafayette, IN 47907 4
KEEP THIS PAGE FOR YOUR INFORMATION Indiana 4-H Entrepreneurship Academy Application Checklist Use this checklist to make sure you submit everything necessary to attend: 300-word essay Complete registration form Team members listed and also enrolled/enrolling (unless you are registering independently) $190 registration fee (check payable to Purdue University) Everything mailed by May 15, 2017 to: 4-H Entrepreneurship Academy 615 W. State St. West Lafayette, IN 47907 Additional details about check in and program requirements will be sent after the application is received by Indiana 4-H. 5
Frequently Asked Questions KEEP THIS PAGE FOR YOUR INFORMATION 1. What will we do? The ultimate goal of the Indiana 4-H Entrepreneurship Academy is for teams to gain real-world experience and skills to create a business pitch. There will be lots of work involved for this opportunity but the pay-off could be huge! 2. Who should participate in this? Indiana high school students who have completed grades 9-12 and have a sincere interest in and passion for entrepreneurship and small business development. Teens should plan to attend with a team of three other friends, classmates, or club members. 3. What if I don t have a team? We will match you with a team at the academy. 4. Is there a selection process? No. As long as you have completed all parts of the application, paid the registration fee, submitted them by May 15, and meet the requirements of the program you will be accepted. This is limited to 30 participants so be sure to enroll yourself and team members as soon as possible. 5. Does every team member have to be a member of Indiana 4-H? No. 6. Do I have to participate as part of a team? Yes. Participating as a team will make the business pitch stronger and provide a better real-world experience. 7. Does my team need to prepare anything ahead of time? Yes. It will be helpful if your team can come to the on-campus orientation in June with a few product/business ideas in mind. This will give you a jump start and make the best use of your time at the Academy. Think about big ideas that fill a need and can have impact in your local community or region. This is your chance to potentially have a big impact in your hometown! Additional details about this will be provided after your application is received. 8. How much does it cost to participate? There is a one-time registration fee of $190 per participant. This covers all meals and lodging while at Purdue University, insurance, and program materials and supplies. 9. I still have more questions. Who can I call? Contact Ryan Wynkoop at 765-494-8435 or rwynkoop@purdue.edu. 6