Showcase Student Registration - Generation-E Institute

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Student Registration Form

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About Your Business
Only one registration form per business please. Please make sure ALL of students/business owners complete this registration form at the same time. Contact information for all students/business owners is required.
Business Name*
Please provide a one sentence description of your business:*
Please note: This will be used in the Showcase program so please make sure it accurately reflects your business!
Name of Charity Contributing to?*
- Humane Society
- Oaks of Righteousness
- Special Olympics
- Make-A-Wish
The Oaks of Righteousness is a Monroe, MI faith-based non-profit that provides a Café, Emergency Food Pantry, Clothes Closet, Life Skills Training, Homeless Shelter, Men’s Class, Grief Support, Alcoholics Anonymous, Heroin Anonymous and Gambling Anonymous. All students are required to donate a portion of their proceeds to a charity.
How many students own the business?*

Student/Owner Information
Please enter information for each student/business owner.
Address - Student/Owner #1*
Street Address Address Line 2 City State ZIP Code
Name - Student/Owner #1*
First Last
Email - Student/Owner #1*
Age - Student/Owner #1*
Phone - Student/Owner #1*
Grade Level - Student/Owner #1*
Student/Owner #2 Information
Name - Student/Owner #2*
First Last
Address - Student/Owner Name #2*
Street Address Address Line 2 City State ZIP Code
Email - Student/Owner #2*
Phone - Student/Owner #2*
Age - Student/Owner #2*
Grade Level - Student/Owner #2*
Student/Owner #3 Information
Name - Student/Owner #3*
First Last
Address - Student/Owner Name #3*
Street Address Address Line 2 City State ZIP Code
Email - Student/Owner #3*
Phone - Student/Owner #3*
Age - Student/Owner #3*
Grade Level - Student/Owner #3*
Student/Owner #4
Name - Student/Owner #4*
First Last
Address - Student/Owner Name #4*
Street Address Address Line 2 City State ZIP Code
Email - Student/Owner #4*
Phone - Student/Owner #4*
Age - Student/Owner #4*
Grade Level - Student/Owner #4*

About Your School/Community Program
Please tell us about your teacher/instructor and the program that helped you launch your business.
What school district are you with?*
- Monroe Public School District
- St. John Campus of the Monroe Catholic Elementary School
School/Program Name:*
Teacher Name:*
Showcase Needs
Lunch will be provided at the Showcase. Does anyone from your business have any dietary restrictions or allergies?*
- No
- Yes
Please indicate the name of the person and what dietary restriction and/or allergy he/she has below.*
Does your display require electricity?*
- Yes
- No
Will you have a product or service to sell at the Showcase?*
- Yes
- No
Please remember to bring change ($10s, $5, $1 and coins) and a cash box or envelope to hold your profits.
- Please do not take or use my photograph in any way.
*Please only check this box if you do not want your photograph taken or used.

Payment Information
Student Registration
Price: $20.00
Payment Options:*
- Credit/Debit Card
- Group Check paid by school or community program
- I'm not sure
Checks Payable: Generation E Institute, 1275 N. Macomb St., Monroe, MI 48162
Total
$0.00
Credit Card*
American Express
Discover
MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name

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1275 N Macomb St

Monroe, MI 48162
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