What is your first name? *

What is your last name? *

What is your email address? *

What is your phone number? (If you qualify, we'll call you) *

What is the name of your company? *

What's your company website? *

Are you the decision maker for the company? *

(if you are not, please list decision maker's name and contact information)

What does your business do? *

(Please describe your industry, services, products, etc.)

Would your business be interesting enough to Shark Tank investors? *

Yes

(Our investors and funding partners are real people and they invest in unique and interesting businesses and ideas)

What is your annual revenue? *

Less than $100k

$100k-$500k

$500k-$1M

$1M-$5M

$5M plus

What is your revenue per month? *

Less than $1,000

$1,000 - $3,000

$3,000 - $5,000

$5,000 - $10,000

$10,000 Plus

What is the length of time incorporated? *

Less than 6 months

6 months to 1 year

1-3 years

3-5 years

5-10 years

Over 10 years

What are your current funding needs? *

$100k - $250k

$250k - $500k

$500k - $1M

$1M+

What is the purpose of funding? *

(Please specify. Example: Expansion, Research & Development, Marketing, Equipment Purchase, Working Capital, etc.)

Have you previously secured funding? *

Yes

If yes, what type of funding have you secured?

(Please specify. Example: Bank Loan, Venture Capital, Angel Investment, Crowdfunding, Other)

Personal credit score range: *

Excellent (800-850)

Very good (740-799)

Good (670-739)

Fair (580-669)

Poor (300-579)

(Please note that if you’re looking to raise money from angel investors, your credit score does not disqualify you.)

Are you looking for... *

Credit (Money from banks)

Capital (Money from people)

For raising capital, you will need a minimum budget of $12k. Do you have this minimum budget? *

Yes, I have $12k

No, I do not have the $12k but I am willing to be resourceful

No and I am not willing to invest

Please share any additional important details that would ensure a successful outcome.

What time zone are you in? *

By submitting this form I confirm that the information provided on this application is accurate and truthful. I also understand that if I want to raise capital from angel investors, I need a minimum budget of $12k.