CUSTOM PROGRAMS IN ENTREPRENEURSHIP & INNOVATION
CLIENT INQUIRY FORM

Organization and Contact Information

The Custom Programs focusing on Entrepreneurship and Innovation within the unique ecosystem of the Silicon Valley, San Francisco and the greater Bay Area provide meaningful, memorable and life-changing learning experiences through a variety of interactive academic and experiential learning activities for a wide range of audiences from graduate and undergraduate students to business leaders, entrepreneurs, and investors.

Please kindly fill out as much information as possible, so we could provide more relevant information for you. Please also note that this program is for organizations interested in bringing a group on site to UC Berkeley Extension. Thank you for submitting your inquiry. You will hear from our office within 48 hours.

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* 1. Organization Name

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* 2. Type of Organization

If you selected “other,” please specify your organization type.

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* 3. Contact Name and Other Information

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Last

Phone Number (Including country code and area code)

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* 4. Organization Address

Address

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Country *

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* 1. Organization Name

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* 2. Type of Organization

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* 3. Contact Name and Other Information

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* 4. Organization Address

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* 5. Website Address