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Become an Academic Ally

First Name

Last Name

Academic Institution

Department

Email

City

State

How did you hear about us?

What do you know about Penumbrella?

What do you know about the Red Rover Alliance?

Why are you interested in Penumbrella and the Red Rover Alliance?

Area/s of Interest

Area/s of Interest

Do you know of any companies that are a good fit for our alliance?

Do you know of any companies that are a good fit for our alliance?
A
B

Do you know of other professors that would be a good fit for our alliance?

Do you know of other professors that would be a good fit for our alliance?
A
B

If you answered yes, tell us--company name, contact info, phone, city, state, and why they'd be a good fit.

Are you interested in becoming a member of the alliance?

Are you interested in becoming a member of the alliance?
A
B
C

If you answered Nope above, may we ask why not?

Sponsor Code

Thank you for your interest in becoming an ally. We will be in touch shortly.