Join Launchzone, A.James Clark School of Engineering, University of Maryland

Launch Zone Map Request Form

map To request that your organization be included in the online version of the Clark School's
"You Are Now Entering the Launch Zone" map, please complete the form below.

The Clark School will make every effort to evaluate your request and include your organization
in the online map in a timely manner.

Thank you.

Your Organization's Name, Location and Contact Information

Organization Name:

Organization Street Address:

City:

State:

Zip:

Organization Phone:

Organization Website:

Your Organization's Type of Work

Other:

Your Organization's Role in Entrepreneurship

Please state your organization’s role in tech entrepreneurship. Select one or more of the following possibilities:

Start-up tech company	State economic development organization
Established tech company that partners with start-ups	Federal agency with tech transfer program
University tech company incubator	Venture firm that works with tech start-ups
County tech company incubator	Business group that advises tech start-ups
County economic development organization	Support firm that provides services to tech start-ups
	Other:

Your Organization's Connection to the Clark School/University of Maryland

Please state your organization’s connection to the Clark School or University of Maryland.
Select one or more of the following possibilities:

Graduate of/former participant in Mtech programs	Graduate of/former participant in Dingman Center programs
Current participant in Mtech programs	Current participant in Dingman Center programs
Prospective participant in Mtech programs	Prospective participant in Dingman Center programs
Current sponsor of Mtech programs	Current Clark School Corporate Partner
Prospective sponsor of Mtech programs	Prospective Clark School Corporate Partner
Federal agency or lab that partners with Mtech programs	Current Clark School/University of Maryland research partner
State agency that partners with Mtech programs	Prospective Clark School/University of Maryland research partner
Established tech corporation that partners with Mtech programs	Current recruiter of Clark School students
Prospective recruiter of Clark School students	Other:

Your Contact Information
The following is needed for ongoing communications and will be kept confidential and not included in the map itself:

Your Name:

Your Title:

Your E-mail Address:

Launch Zone Map