Dream It | Do It

Thank you for your interest in the Dream It | Do It Camp to Inspire Future Entrepreneurs at UCC. Please fill out the form below. Note, * indicates a required field.

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Applicant

Name*

First Last

Address*

Street Address City State ZIP Code

Phone*

Email*

Date of Birth*

Parent/Guardian

Name*

First Last

Address*

Street Address City State ZIP Code

Phone*

Email*

Date of Birth*

Emergency Contact

Name*

First Last

Address*

Street Address City State ZIP Code

Primary Phone*

Secondary Phone

Please Respond to the Following Questions.

School Name*

Grade*

What entrepreneurial activities or programs have you been part of previously, if any? (Max. 100 words)*

What inspired you to apply for this camp? (100-200 words)*

What do you hope to gain from this camp? (50-100 words)*

Do you have any volunteering experiences? If yes, please describe. (Max. 50 words)*

What do you like to do in your free time or what are you most passionate about doing? (Max. 50 words)*

How would you describe your personality in three words? (Max. 3 words)*

Application Information: Application to the Dream It | Do It Camp to Inspire Future Entrepreneurs (Camp) is open only to high school juniors and seniors (11th & 12th grade) currently enrolled at a school in Douglas County, Oregon. Application must be submitted online no later than May 12 in order to be considered for the Camp. Applications will be reviewed by Camp staff and notifications made in early May about acceptance to the Camp or placement on a waitlist. Final admittance to the Camp requires participant and parent/legal guardian acceptance of the Camp Participation Agreement.

Attendance Requirements: The Camp is a five-day event, requiring attendance from 9 am until 4 pm each day.

Participation Expectations: Each participant is expected to actively participate in each day’s activities with a high level of personal engagement. Lunch and snacks will be provided each day at no extra cost. Cell phones or other personal devices may not be utilized during active Camp sessions. Short breaks will be scheduled throughout the day at which time participants may access personal phones and email.

Camp Size: Space in the Camp is limited to 25 individual students. A short waitlist will be maintained in the case of cancellation.

By signing below, you acknowledge and agree to the following:

Submission of this application does not guarantee you a place in the Camp. Applications will be reviewed by the Camp committee and notifications will be sent to all applicants regarding application status in mid May. Completed applications must submitted online no later than May 12, 2024. Final admittance into the Camp will require signing a Camp Participation Agreement, signed by the student participant and their parent or legal guardian prior to the start of Camp.

Student Signature*

Date*

Parent/Legal Guardian Signature*

Date*

Please List Any Food Sensitivities/Allergies

Applications must be received by the SBDC no later than May 12, 2024.

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Umpqua Community College

Dream It | Do It

Applicant

Parent/Guardian

Emergency Contact

Please Respond to the Following Questions.

Applications must be received by the SBDC no later than May 12, 2024.

Campus

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