2017 Tech Surge Registration Form Question Title * 1. Venture Name: Question Title * 2. Case Number(s) and Title(s) of UC IP you are using: Question Title * 3. Briefly describe your venture idea. Question Title * 4. In what area(s) of expertise do you need need the most assistance? (Be as detailed as possible, as this will be what information we use to pair you with members of our Experts-in-Residence network.) Question Title * 5. Team Member #1 Name Email UCI Affiliation - Faculty, Staff, Student (specify undergrad or grad and school), Other Question Title * 6. Team Member #2 Name Email UCI Affiliation - Faculty, Staff, Student (specify undergrad or grad and school), Other Question Title * 7. Team Member #3 Name Email UCI Affiliation - Faculty, Staff, Student (specify undergrad or grad and school), Other Question Title * 8. Team Member #4 Name Email UCI Affiliation - Faculty, Staff, Student (specify undergrad or grad and school), Other Question Title * 9. Team Member #5 Name Email UCI Affiliation - Faculty, Staff, Student (specify undergrad or grad and school), Other Question Title * 10. Team Member #6 Name Email UCI Affiliation - Faculty, Staff, Student (specify undergrad or grad and school), Other Done
