First Name:       Last name:      

AAsdd Email Address:       Confirm Email Address      

Address:       City:       Country/Region      

State/Province       State:      Zip/Postal Code     

Phone:       Industry      

Organization       Job Title      

Are you an investor or source of capital?

Yes, I'm an investor or represent a company that invests or other investors.

I'm not an investor, but I'm a source of capital.
No, neither of these.

Are you ready to invest this month if you learn of a good investing opportunity?

Yes No Not this month, but in Next 3 months.

Not this month, but in Next 6 months Not this month, but in Next 12 months

What is the amount you as an individual or your company typically invest? 

$25,000 to $100,000 $1,000,000 t0 $5,000,000

$101,000 to $500,00 $5,000,000+
$501,000 to $1,000,000 I am not an investor 

What type of investment structure do you prefer to invest in?

Convertible Note Unsecured Debt

SAFE Corporate Bond
Preferred Equity Revenue Share
Common Stock I am not an investor.
Secured Debt Other

What Industries do you normally invest in? 

 Legalized Cannabis or Hemp CleanTech
FinTech Technology
AgriTech GreenTech
BioTech EduTech
SaaS Consumer Packaged Good
Real Estate Other
I am not an investor

What stage to you typically invest in? 

Pre-Seed Beyond Series A

Seed I am not an investor
Series A

Would you like to be matched to any of the companies presenting here today or have
presented in our other events? *

Yes No Contact me and ask me first 

Would you like to receive free samples from companies presenting or who have presented in
the past? 

Yes (please provide address above) No

Do you need help raising capital for your company or a company you represent? 

Yes No

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