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Employer Application

Please make sure to read the Employer Information before signing up.

Thank you for your interest in the Mayfield Fellows Program (MFP). This form is used to collect profile information about your company and will be used for two purposes:

This information will be kept confidential and will be available only to our students through a password-protected site.

Before completing this form, please be sure you are familiar with the general criteria for participating, listed in the Employer Information section.

Please fill out the following information and submit it using the form below. If there is any information which is confidential, please write “confidential” and we will contact you.

Company Name:
Location:
Website: http://
Contact Person’s Name:
Contact Person’s Email:
Contact Person’s Phone:
Nature of Business:
Main Product(s)/Service(s):
Date Founded:
Size/Stage of Development:
Source of Funding: (e.g. Kleiner Perkins and Mayfield) This is very important.
Job Description:
Special Qualifications for Employee:
Other relevant information:
Have you participated in MFP before? (Yes or No)
How did you become aware of MFP?
What year is it?
(spam test)