UBC Venture Capital / Private Equity Club

Agent Application Form

Due: January 29th, at noon

Name: Student Number:

Year / Desired Major: E-mail Address:

The UBC VCPE Clean Venture Competition is a entrepreneur-driven conference in Mid-March. In this unique compe-
tition, students will compete as a member of either a "Venture Capital Team" (VC Team) or an "Entrepreneur Team".
On the day of the competition, students in the "Entrepreneur Teams" will be given an opportunity to develop a new
enterprise that meets requirements specified on the day of the competition. As an agent, you will be dealing with the
logistics/marketing aspects of the competition. You will also be trained under the VCPE’s cross-functional leadership
strategy, one that will be critical to your success in the future. More information can be found at www.ubcvcpe.com.
Note: This application is used in place of a resume/cover letter.

1. How did you hear about the UBC VCPE and its Clean Venture Case Competition?

a) Word of Mouth
b) UBC VCPE website
c) CUS Newsletter/Website
d) Other Explain:

2. Are you currently a member of the UBC VCPE?

e) Yes
f) No
What interests you most about the agent position and/or venture capital / private equity?

Please fill in the table highlighting some experiences, awards, or qualifications that you feel would contribute to a
successful agent. (They could deal with leadership, business, community service, and related topics.)

Awards/Qualifications:

Experiences:

Please hand in to the mailbox of Dylan Callow, in CG Lounge (Henry Angus) 302, or by e-mail at dylan.callow@gmail.com.