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Propel Intake Form

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Thank you for your interest in the entrepreneurship centre at Western University. In order to best serve your needs, and to comply with our government reporting requirements, we require the following information for our files.

Once you complete this form, our business analyst will reach out to you to set up a one-on-one meeting to learn more about your idea or business. 
1. Contact Information *This question is required.
2. Student Information  *This question is required.
Are you a 
Are you an international student?
3. Company/Idea Information 
Please enter the number of people involved, and their current status *This question is required.
Please provide us with the following information about your co-founders *This question is required.
Space Cell Co-Founder 1Co-Founder 2Co-Founder 3Co-Founder 4
Name
Faculty
Email