Venture Acceleration Program Basic Information Form About You Name * E-Mail * Phone Number * Address * City Postal Code Technology area of expertise? Other area of expertise? Present job or business? Do you have a venture? YesNo What Do You Want? Please refer to the description of services Do you wish to be a member of the AG-Tech Venture Acceleration Program? YesNoWould you like to take advantage of advertising? YesNoWould you like to take the Market Validation Training? YesNoAre you interested in becoming a mentor? YesNoWould you like to submit your company to be in our services database? YesNoWould you be interested in attending the CEO Round Table? YesNoAre you looking for investment for your venture? YesNo Acceptance to Register for the AG-Tech Venture Acceleration Program I accept to register for the AG-Tech Venture Acceleration Program and I promise to abide by the following rules of the AG-Tech Venture Acceleration Program. Member agrees to use the services and material for their own use and not for others. Member agrees not to abuse any SRCTec and AVAP facilities or materials. Member agrees to make best efforts to punctually attend AVAP events. Member agrees to hold any information that they learn about other ventures or about the SRCTec or AVAP as confidential and not reveal it to others. Member agrees to pay any fees for programs or events promptly within 30 days. Member agrees to uphold the good name of SRCTec at all times. By checking the box here I ACCEPT to register for the AG-Tech Venture Acceleration Program.