Intent to Compete – New Venture Name of team leader(Required) First Last Student ID numberAddress(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country UWM Email Personal email(Required) Year in school(Required) Freshmen Sophomore Junior Senior Graduate student Alumnus Major or Program of Study(Required)UWM status(Required) Undergraduate student in good standing Graduate student in good standing Alumnus Name of VentureBrief description of ventureName of team member #1(Required) First Last Email of team member 1(Required) UWM status of team member #1(Required) Undergraduate student in good standing Graduate student in good standing UWM Alum Non-UWM team member Expected graduation year(Required)Student ID number of team member #1 (if applicable)Name of team member #2 First Last Email of team member #2 UWM status of team member #2 Undergraduate student in good standing Graduated student in good standing Graduate student in good standing UWM Alum Non-UWM team member Expected graduation yearStudent ID number of team member #2 (if applicable)Name of team member #3 First Last Email of team member #3 UWM status of team member #3 Undergraduate student in good standing Graduated student in good standing Graduate student in good standing UWM Alum Non-UWM team member Expected graduation yearStudent ID number of team member #3 (if applicable)Name of team member #4 First Last Email of team member #4 UWM status of team member #4 Undergraduate student in good standing Graduated student in good standing Graduate student in good standing UWM Alum Non-UWM team member Expected graduation yearStudent ID number of team member #4 (if applicable)I have read, understood, and complied with all Eligibility Criteria for the LaMacchia Competition.(Required) I agree I disagree I acknowledge and understand that it is a violation of certain state and federal laws, including federal copyright laws, to use the original works of others without their permission.(Required) I agree I disagree I agree to indemnify and hold harmless, the University of Wisconsin-Milwaukee, the UWM Foundation and its agents, as well as the award's sponsors, judges and attendees, from damages or loss that may result from my failure to secure any necessary rights and permissions, including against claims of copyright infringement and unauthorized use.(Required) I agree I disagree I agree to abide by the decision of the LaMacchia Selection Committee.(Required) I agree I disagree I have read and agree to the terms and conditions of the award as outlined in the "About the Awards" section.(Required) I agree I disagree By submitting this form, I am hereby consenting to the creation, enforcement and use of my electronic signature to enter into the subsequent "Competition Disclosures." I understand that by clicking "I consent", I will be granted access to review the "Competition Disclosures" for purposes of registering for the LaMacchia New Venture Business Plan Competition. If I do not wish to execute the "Competition Disclosures" in electronic format, I understand I have the option of executing the "Competition Disclosures" in paper format. If I wish to do so, I should contact Kennedy Wiegel. I understand that if I do not execute the "Competition Disclosures" in either electronic or paper form, I will not be permitted to register for the LaMacchia New Venture Business Plan Competition. By clicking "I consent" below, I acknowledge that I am able to print/download a copy of the "Competition Disclosures" if I wish to retain a copy of it and I further agree that I will not allow third parties to use my password or otherwise access my electronic application for the LaMacchia New Venture Business Plan Competition.(Required) I consent I do not consent I agree to abide by the decision of the LaMacchia Selection Committee and the competition staff.(Required) I agree I disagree