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NBAI
Investor Profile Form
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Please complete the following investor profile, so that we may better
understand your investment criteria and contact you about matching
opportunities. This profile is an requirement for attending
investor events. Your information will remain Private,
Confidential,
and will never be sold or used without your authorization. At any time
you may elect to remove your information from our database.
Directions:
When selecting more than one item.
Hold the Ctrl key and select
all that apply.
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| First Name * |
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| Last Name * |
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| Phone No. |
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| Email * |
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| How did you hear about us? |
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| What is the name of the
person or site who referred you? |
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| Company |
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| Title |
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| Salutation |
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| Street Address |
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| Suite or Bldg # |
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| Zip Code |
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| City |
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| State |
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| Country |
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| Website |
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| Cell Phone |
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| Alternate Phone No. |
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| Do you invest your own money? |
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| If no, what is your
relationship with investors? |
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Section A: Investor Background
Complete this section if you directly invest your money
into private equity companies or have the intention of doing so. When
completed, proceed to Section C.
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Do you have investments in
the stock market?
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| What is the total value of
your real estate holdings? |
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Have you ever invested in a private company?
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If yes, how many private companies have you invested in?
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What is the most you have invested in a private company at one time?
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What is the size of your
private investment portfolio?
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How many of those have
provided a return on your investment?
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Do you plan to start investing this year?
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| Are you an accredited
investor? |
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| Are you an active member of
any Angel Investor Networks or Funds? |
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| Name of Angel Groups you
participate in. |
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Section B: Advisor or Representative
of Investors or Funds
Complete
this section if you are a
financial advisor, CPA, lawyer, broker dealer, other representative of
investors, funds, manage or influence other's investments.
When
completed, proceed to Section C.
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Do you have direct access to
active angel investors or an investment funds?
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How many accredited investors
do you directly work with?
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What is the average
investment they make in a company?
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What is the total capital
from the investor(s) or funds you represent?
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What type of investments do
they make?
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How long have you been working with private equity investors?
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If you work with Funds, what kind do you represent?
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Section C: Investment Preferences
Complete
this section so we may better understand the type of opportunity best
suited for your experience and preferences.
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| What are your industry
preferences?
Hold
the Ctrl key and select all that apply.
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| What business development
stage is preferred?
Hold
the Ctrl key and select all that apply.
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| What Investment types are
preferred?
Hold
the Ctrl key and select all that apply.
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| What are the involvement
preferences?
Hold
the Ctrl key and select all that apply.
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| Please
recommend other investors to our events by sending their name, phone,
and email address. We will not add them to our regular
database
until we have confirmed their interest.
Please
list any comments.
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5
Thank You!
Please
click the submit button now.
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