Student Referral Application

How It Works

Do you know young, aspiring entrepreneurs? Are they creative and motivated, or looking for their spark? Please introduce us by completing the form below!

Once referred, students will receive information about YEA and how to apply.

Fill Out Form

Are you a student?

If you are, skip this step and complete the student application form directly.

Apply Now

Your Name

First Name

Last Name

Your Email Address

Your Mobile Phone

(###)

###

####

I am a(n)...

Organization

Name of your school or employer. If none, enter: None

My main affiliation

I heard about YEA BR from...

Name of the source I heard about YEA BR from...

Name(s) of school, teacher, business, publication, friend, etc.

Student and Parent/Guardian Information

Your relationship/how you know the student

Example: Teacher, guidance counselor, advisor

Student Name

First Name

Last Name

Student Email

IMPORTANT: this must be the student's email address, NOT the parent/guardian's.

Student Mobile

(###)

###

####

School

(if known)

Parent/Guardian Name

First Name

Last Name

Parent/Guardian Relationship to Student

Parent/Guardian Email

IMPORTANT: this must be the parent/guardian's email address, NOT the student's.

Parent/Guardian Mobile Phone

(###)

###

####

Parent/Guardian Employer

If any

Recommendation / Comments

Please provide details about the qualities you have observed in this student, and what makes them a suitable candidate for the Academy.

Student Referral Application

How It Works

Are you a student?

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