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Venture Capital

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Angel Sign-up Form

Please complete the following information to qualify as an "accredited" investor. After you have completed the information below, click to submit the annual $95 membership fee. You will then receive a private passcode to use when ordering the Venture Profile summary, "elevator pitches" outlining the detailed information and/or business plans on any of the current ventures registered for funding.

*Angel Membership Profile:

*Fields with an asterisk are mandatory.
*First Name:  
*Last Name:  
Title:  
Company:  
*Address:  
*City:  
*State:  
*Zip Code:  
Country:  
*Phone:  
Fax:  
*E-mail:  
Website:  
Contact:  

Years in Business:

How did you find us?   

Which industries you are most interested in:

Aerospace Aircraft
Agricultural Automotive
Bio-Tech Communications
Computer Software Computer Hardware
Construction Consumer Products
Defense Education
Electronics Energy
Entertainment Environment
Film/Television Financial Services
Food Forestry/Fish
Gaming Health/Fitness
Industrial Insurance
Inernet/E-commerce Lodging/Resorts
Manufacturing Marine
Medical Natural Resources
Oil/Gas Pharmaceuticals
Publishing/Printing Real Estate/Development
Security Space Technology
Technology Textiles
Transportation Any of the above

Other:

Countries of interest:
United States Canada
United Kingdom Western Europe
Carribean Eastern Europe
South America South Pacific
Australia Malaysia
Hong Kong China
New Zealand Japan
Singapore Worldwide

*Minimum amount you have previously invested:

*Maximum amount you have previously invested:

*Current portfolio value:

Comments:

*Declaration of Accreditation: No investment is guaranteed. Because Venture Capital is considered high risk investment, in order to pre-qualify as an "accredited" Angel investor and receive specific information on current projects, you must fall within the legal definition of the Securities and Exchange Commission (SEC) in Rule 501 of Regulation D, as an individual with one of the following criteria. Again, if you have any further questions about these qualifications, please visit the Securities and Exchange Commission's web site at www.sec.gov.

You are legally responsible for the truth of this declaration and can be held responsible for any false and/or incorrect information submitted:

Individually, or jointly with my spouse, I/we have a net worth of more than $1 million dollars valued at cost, net of encumbrances.

I have an income of more than $200,000 annually for the past two consecutive years.

My spouse and I have had a combined income of more than $300,000 annually for the past two consecutive years.

Please include me in periodic e-mail notices that offer advance notice of and discounts for investment conferences, seminars and events.

Welcome to the Island Connections Angel Network! We look forward to working with you.

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All rights reserved © 2004

corner.jpg (19010 bytes) *Disclaimer

This Internet site is designed to provide accurate and authoritative information with regard to the subject matter. However, it is not a substitute for legal, accounting or other professional services. No guarantees are provided for funding services. These investment opportunities have not been approved or disapproved by the Securities and Exchange Commission nor has the Commission passed upon the accuracy or adequacy of these private offerings. This is not nor shall be construed as an offer to buy or sell securities. Business plans or additional details on any of these ventures are available only to accredited investors or investment professionals upon registering on the network and use of private access password. Neither Island Connections, its management or affiliates make any representation or warranty, expressed or implied, as to the accuracy of the information contained within the business plans either orally or written. The aforementioned parties expressly disclaim any and all liability resulting from the use of such information which is subject to errors or omissions including legal, financial or otherwise. Financial projections are assumptions based on a variety of factors which may not prove to be correct. Prospective investors should carefully review and consider the risk factors on any venture prior to making an investment. Venture capital is considered high risk without any guarantees of financial return and should only be done under the guidance of your own professional advisors.