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2. Summit County Resident Ice House Program Application
   Taking (10) Applicants
4. First Name:*
5. Last Name:*
7. Address:*
9. City:
10. State:
11. Zip:
13. Phone:*
14. Email:*
16. Present Occupation:
17. Check any of the following that apply to you:
    Please check NONE OF THE ABOVE if none apply.*

    1. Have owned a business
    2. Currently own a business
    3. Am working on a business idea
    4. I have a computer and access to the internet
    5. I'am a high school senior or will be senior next fall
    6. None of the Above
19. How did you learn about the Ice House Program?*
21. What do you believe an Entrepreneur is?
    Please limit your response to 200 words or less.*
23. What do you envision needing in your life in order to be a success?
    Please limit your response to 200 words or less.*
25. How do you believe your community will benefit from your participation in the Ice House Program?
    Please limit your response to 200 words or less.*
Leave This Blank:


27. 1. Receive an email copy of this form.
28. Email address

    This field is not part of the form submission.

29. Submit

* indicates a required field