Venture Capital Review Application

Legal Business Name *

Trade Name/DEA (If different than legal name) *

Industry *

Entity Type *

Tax ID (Federal EIN) *

D-U-N-S # 0 of 9 max characters. Numeric characters only.

Business Start Date * Please indicate date of incorporation, if applicable.

# of Employees * Please enter a number greater than or equal to 1.

Street Address

Address Line 2

City

State

Phone *

Email *

How much money are you seeking?

What percent of the business do you own?

What is your average monthly revenue over the last 3 months? $0 $1–4K $5k–7k $8K–14k $15K–19k $20K–49k $50K–79k $80K+

What are your annual gross revenue? <$50K $50K+ $100K+ $250K+ $500K+ $1MM+ $5MM+

Upload Pitch Deck or Business Plan Upload multiple files as zip. Only Zip files allowed.

Have you raised and funding? If so, how much? Did you give away equity?

Select the Topic of Discussion Self-Funding Pre-Seed Series A Equity Crowdfunding Friends & Family Seed Series B Coin/Token Raise

Please list any sources of business credit or funding the business currently has or has recently applied for in the past 180 days (investor or bank)

Best Day and Time Best date and time to speak with your business adviser (M-F, 9-4 pm Pacific)?