Section I : Particulars of Group Leader & Members â Every team shall consist of 2 to 5 members. (including the gro
GLOBAL STUDENT START HUB - Entrepreneurship Contest Executive Summary Form
Reference No.
Handling of Information and Personal Data 1.
2. 3.
4.
Your provision of all the personal data requested in this form is obligatory. Failure to provide these data may affect the processing and result of your application. The personal data and information provided in this Form and in supplementary document(s), if any, will be used by the Office of Student Development (OSD) for activities relating to: (i) processing of this application (ii) the payment process of the cash prize The personal data and information collected in this application may be disclosed to relevant parties, including the Finance Office/other units of PolyU: i) for the purpose mentioned in paragraph 2 above, and ii) where such disclosure is authorized or required by law. Your application information will be kept in OSD for no more than 4 years.
Please complete Section I to Section V. Section I : Particulars of Group Leader & Members – Every team shall consist of 2 to 5 members (including the group leader), with 50% or more of the group members being the members of Entrepreneurship Society (ES) of OSD, PolyU. Group Leader - The key liaison between the team and OSD throughout the contest. Name (In English) Department / School Student no. Year of study
Group member 1 Name (In English) Year of study
Group member 2 Name (In English) Year of study
Mobile no.
Tick the box if you are currently a PolyU full-time UGC-funded undergraduate degree students Tick the box if you are currently a member of Entrepreneurship Society (ES) of OSD, PolyU
Department / School
Student no.
Mobile no.
Tick the box if you are currently a PolyU full-time UGC-funded undergraduate degree students Tick the box if you are currently a member of Entrepreneurship Society (ES) of OSD, PolyU
Department / School
Student no.
Mobile no.
Tick the box if you are currently a PolyU full-time UGC-funded undergraduate degree students Tick the box if you are currently a member of Entrepreneurship Society (ES) of OSD, PolyU
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Group member 3 Name (In English) Year of study
Group member 4 Name (In English) Year of study
Department / School
Student no.
Mobile no.
Tick the box if you are currently a PolyU full-time UGC-funded undergraduate degree students Tick the box if you are currently a member of Entrepreneurship Society (ES) of OSD, PolyU
Department / School
Student no.
Mobile no.
Tick the box if you are currently a PolyU full-time UGC-funded undergraduate degree students Tick the box if you are currently a member of Entrepreneurship Society (ES) of OSD, PolyU
Section II : Details of the Business Idea Name of Business Idea: Description of the business concept:-
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* Please use separate sheet(s) if necessary Page 3 of 5
Section III : Team members’ agreement (to be signed by all team members): (i) All team members have read and understand the Guidelines and Terms & Conditions of the “Contest”. (ii) Each member understands that the best effort has been made by the PolyU and its participants to ensure the confidentiality of each business plan. (iii) Each Contestant agrees to voluntarily release each PolyU’s staff and its representatives from any further liabilities, responsibilities, and accountabilities relating to or arising from their involvement in the “Contest”.
Signature of Group Leader
Full Name in Block Letters
Signature of Group Member 1
Full Name in Block Letters
Signature of Group Member 2
Full Name in Block Letters
Signature of Group Member 3
Full Name in Block Letters
Signature of Group Member 4
Full Name in Block Letters
Date
(Student No.: ________________)
Date
(Student No.: ________________)
Date
(Student No.: ________________)
Date
(Student No.: ________________)
Date
(Student No.: ________________)
Section IV : Team advisor’s agreement (optional) Each team can invite a university faculty member to act as the team’s advisor I agree to be the Advisor of this contesting team to take part in the “Contest”. Name
Tel no.
Department
Position
Date
Signature
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Section V: Declaration (Please put a ‘’ in the appropriate box(es) ) I have read and understand the Application Guidelines of the “Contest”. The information given by me in this form is accurate and original to the best of my knowledge. I authorize OSD to handle and use the personal data/information provided by me and any supplementary information as required by the University for activities relating to the handling and assessment of this application. I understand the above personal data/information will be treated with strict confidence and kept for a period of no more than four years under normal circumstances. I give my consent to PolyU to share the information in this application with the PolyU community and to use it for publicity purpose. I understand I have the right to gain access and make correction to the personal data provided by me in this application form. Such request should be made in writing and email to
[email protected] (Attn: Head of OSD). I also understand this application form and the related documents submitted are not returnable.
Signature of Group Leader:
Date: (on behalf of group members)
FULL Name in Block Letters: (Student No.:
)
Please read the Terms & Conditions and FAQs at https://goo.gl/8uHGvj carefully before submitting the form. Completed application form should be returned to the collection box (Box No. B2) in Room QT308 on or before 5:00 p.m., 8 December 2017.
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