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All personal information provided will not be shared with third parties. We require identification as part of our Know Your Client (KYC) and Anti-money Laundering (AML) policy, this is to ensure protection for both founders and investors. Information transferred is sent securely through SSL. We estimate it will take around 20 minutes to complete this form.

1Personal Details

2Business Details

3Capital Details

4Pitch

Name
Title First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Date of birth
MM slash DD slash YYYY
Phone
Email
Photo ID (passport or Driving License}
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Accepted file types: jpg, pdf, png, pptx, docx, exls, Max. file size: 256 MB.
Proof of Address (dated within the last 3 months - Personal Utility bill or bank statement)
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Registered Business Name
Trading as Name
Company Registration Number
Date Company was Registered
MM slash DD slash YYYY
Business Registered Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Company Formation Certificate
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Accepted file types: jpg, pdf, png, pptx, docx, exls, Max. file size: 256 MB.
What is your business industry
What was your business revenue in the last 12 months if you are already generating revenue
Please explain in your own words what your business does

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Funding Stage
Amount Required to Raise Here
Amount Previously Raised to date prior to this funding round
Amount Raised so far for this funding round
Amount you have invested personally into the company since its inception
Percentage of equity you are giving in return for this funding round
What is the number of shares this percentage represents
What is the share price
What is the exit stratergy for shareholders
When do you assume shareholders can exit by
What is your company valuation
Please explain what the funds raised will be used for
Shareholder agreement - Please provide if you have one
Accepted file types: jpg, pdf, png, pptx, docx, exls, Max. file size: 256 MB.
Term sheet - Please provide if you have one
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Upload your Pitch deck
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Upload your company teaser
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Upload your company 3 or 5 year cash forecast
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Accepted file types: jpg, pdf, png, pptx, docx, exls, Max. file size: 256 MB.
Tell us what your elevator pitch is
If your company has a story, tell us here what it is
Please tell us any additional information you think might be useful
Please upload any additional documents you feel may be useful
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