FINAL REPORT

(Alberta InnovatesStudent and Recent Graduate Entrepreneur Support Program)

All capitalized words or terms which are not defined within this Final Report Form (the “Report”) have the respective meaning as set out in the Program Guide for the Student and Recent Graduate Entrepreneur Support Program(the “Guide”). In this Report, the term “you” and “Applicant” are used interchangeably. As a reminder, “Project” means the activity performed over the duration of the Investment.

Part 1 Final Report Instructions:

Pursuant to Section 6.4 of the Guide, please complete the following Report on behalf of the Applicant. As a reminder, “Applicant” means the company or entity that completed and submitted the Application. The completed Report must be signed by an authorized representative of the Applicant and submitted no later than thirty (30) days after the completion of the Project.

It is essential that you have read, and that you understand the Guide before completing this Report. The Guide contains the terms and conditions which are binding on each of the Applicant. For more information regarding the use of the Report, please refer to the Guide.

The completed Report must be submitted by email to as a PDF, for Alberta Innovates’ consideration. If you require assistance in completing the Report, please email . An incomplete Report, or a Report that is not in the current standard form provided on Alberta Innovates’ webpage, will not be accepted by Alberta Innovates.

Alberta Innovates may approve, request specific changes, or decline approval of this Report as determined in its sole discretion, and Alberta Innovates’ decision is binding on all parties. Upon its review, Alberta Innovates will indicate its decision to approve or decline the Report at the bottom of this document and will provide a scanned copy of this completed Report by email to the Applicant.

Part 2 Freedom of Information and Protection of Privacy Act (Alberta) (“FOIP”):

Alberta Innovates is governed by FOIP. This means Alberta Innovates can be compelled to disclose the information received under this Application, or other information delivered to Alberta Innovates in relation to the Project, when an access request is made by anyone in the general public.

In the event an access request is received by Alberta Innovates, exceptions to disclosure within FOIP may apply. If an exception to disclosure applies, certain information may be withheld from disclosure. Applicants are encouraged to familiarize themselves with FOIP. Information regarding FOIP can be found at

Part 3 Publication of Non-Confidential Information by Alberta Innovates

Pursuant to Section 7.12 of the Guide, Alberta Innovates may publish and/or disseminate in the public domain certain information contained within this Report as a way to showcase the outcomes generated by the Investments made by Alberta Innovates in the Province of Alberta. On this basis, Alberta Innovates deems the following information in this Report to be non-confidential and subject to publication and/or dissemination by Alberta Innovates in its sole discretion at any time:

Section I: Contact Information – Applicant’s Legal Name, Applicant Representative’s Name

Section II: Project Summary – Non-Confidential Summary

Section II: Program Metrics

Date: Click here to enter a date.

Record Number: Add Text Here

Project Start Date: Click here to enter a date.

Project Completion Date: Click here to enter a date.

Project Title: Add Text Here

SECTION I: CONTACT INFORMATION

Applicant Information

Name of Applicant:

Department involved with the Project (if applicable):

Faculty involved with the Project (if applicable):

Civic Address line 1:

Civic Address line 2 (if applicable):

City: Province/State: Country: Postal Code:

Applicant’s Office Phone Number:

Applicant’s Website (if applicable):

Applicant Representative

Salutation: Select from Dropdown

First Name: Middle Name (if applicable): Last Name:

Position within the Applicant’s Organization:

If the Representative’s mailing address is different from the Applicant’s civic address, provide that Address:

Direct Business Phone Number:

Cell Phone Number:

Business Email Address:

If any of the information in SECTION I is different from Section 6.0 of the Student and Recent Graduate Entrepreneur Support Agreement, please identify the changes:

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If any of these changes are as a result of a name change or Change of Control, complete the following:

New Name: Add text here

SECTION II: PROJECT SUMMARY

Non-Confidential Summary

Provide a non-confidential summary of the Project in its entirety.

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Confidential Summary

Did the Project proceed as expected? Please Select

Provide a more detailed description of the Project.

Provide details regarding the following:

  • demonstrate how the Project met the expected outcomes stated in the Application. Clearly tie this information to the submitted information in the project section of the Application which states “how does the Project support the five (5) main Desired Outcomes”.
  • were you able to achieve the milestones and deliverables as outlined in the submitted application? Clearly tie this information to the information in the Milestone Table of the submitted application form;
  • deliverables and milestones not achieved and the reasons why;
  • impact and management of any setbacks or challenges encountered;
  • new or unforeseen outcomes or lessons learned;
  • highlights and successes
  • any other details you think will help Alberta Innovates assess the outcomes of your Project.

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Program Metrics

# of Participants:
Number of Participants involved in the Project – high school Participants
Number of Participants involved in the Project – undergraduate Participants
Number of Participants involved in the Project – graduate Participants
Number of Participants involved in the Project – recent graduates
Number of Participants involved in the Project – other
Add the events listed in your Application below and the number of Participants that attended each event
Name of Event:
Name of Event:
Name of Event:
Name of Event:
Name of Event:
If a Participant survey was distributed, overall Participant satisfaction level (# of participants satisfied with the approach to learning about entrepreneurship) / Participants out of a Total of Participants Surveyed
If a Participant survey was distributed, the # of Participants surveyed indicating that they have learned valuable skills that they will use in the future for job skills, career development, start-up readiness, etc. / Participantsout of a Total of ParticipantsSurveyed
If a Mentor survey was distributed,the # of Mentors surveyed indicating that they gained value from the mentoring experience. / Mentors out of a Total of Mentors Surveyed
If a Mentor survey was distributed, # of Mentors surveyed indicating they are willing to continue mentoring / Mentors out of a Total of Mentors Surveyed
If applicable, # of Participants who have expressed interest in creating companies and will commercialize or continue commercializing their idea / Participants out of a Total of Participants Surveyed
What is the cost of the Program per Participant? / $ Per Participant

SECTION III:FINANCIAL SUMMARY

Part A:

Provide a breakdown of use of funds below:

Expense (Provide a summary of the Eligible Costs) / Amount Approved
in Agreement / Actuals
$ / $
$ / $
$ / $
$ / $
$ / $
$ / $
$ / $
$ / $
$ / $
$ / $
$ / $
$ / $
$ / $
$ / $
$ / $
$ / $
$ / $
$ / $
Grand Total / $

Part B:

Provide a summary of actual co-funders and their contributions specifically leveraged funding.

Summary of Leverage Funding / Type (eg. in-kind, cash, etc) / Amount
$
$
$
$
$
$
$
$
$
$
Grand Total / $

SECTION IV – COMPETITION OVERVIEW

If a component of your Project involved a competition for Participants, please complete the following:

Competition Summary

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Judging & Mentorship Structure (with background of individuals)

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Winner Information 1st Place:

Winner’s Name and/or company name

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Winner’s contact information:

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Non-confidential summary of project/presentation provided to judges:

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Amount of prize money awarded:

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What is the intended use of the prize money? Were guidelines instituted regarding use of funds for participants? If yes, what were the guidelines?

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Winner Information (If a second and third place place prize was awarded, please complete the following sections:

Winner Information 2nd Place:

Winner’s Name and/or company name

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Winner’s contact information

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Non-confidential summary of project/presentation provided to judges

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Amount of prize money awarded

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What is the intended use of the prize money? Were guidelines instituted regarding use of funds for participants? If yes, what were the guidelines?

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Winner Information 3rd Place:

Winner’s Name and/or company name

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Winner’s contact information

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Non-confidential summary of project/presentation provided to judges

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Amount of prize money awarded

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What is the intended use of the prize money? Were guidelines instituted regarding use of funds for participants? If yes, what were the guidelines?

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SECTION V - NEXT STEPS

What future plans does the institution have to continue entrepreneurial programming for students and recent graduates? What happens now?

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Does the Applicant intend to Participate in the Student and Recent Graduate Entrepreneur Support Program in upcoming years? Please Select

Any Additional Information You Wish to Provide For Clarification or Information to Alberta Innovates

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Comments to Alberta Innovates

To assist Alberta Innovates in our efforts to constantly improve our programs and services, please provide any comments, concerns, or suggestions you may have as a result of your experience during the Project.

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SECTION VI– Participant Information

Please attach a list of Participant first and last names and email address for those who have provided their consent. AI will contact these individuals to follow-up regarding success stories and to complete surveys regarding the Program, as per Section 2.0 of the Agreement.

SECTION VII– ACKNOWLEDGEMENTS

Name of the Applicant: Add Text Here
By signing below, I, as the representative of the Applicant as named in Section 6.0 of the Agreement, legally represent for and on behalf of the Applicant thatall information contained in this Final Report is true and accurate and acknowledge and consent to the dissemination/publication of non-confidential information by Alberta Innovates as outlined in Part 3 of this Report. I further confirm that all required attachments are included with this report.
Name of Representative for and on behalf of the Applicant:
Add Text Here
Signature: / Date: / Click here to enter a date. /