Capital Solicitation Form
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(* required field )

1. Head Office Location 
  Region
  Country
  State / Province
2. Industry Group
3. Type of Company *
(one line description of your company)
(e.g., Motion Picture Production, Property Development, Circuit Board Manufacturer)
4. Investment Amount Sought
5. Minimum Amount from any one Investor
6. Type of Investors Preferred
7. Financing Stage
8. Current Annual Sales Range under US$500,000       US$500,000 - US$1M      
US$1M - US$2M       US$2M - US$10M      
more than US$10M      
9. Estimated Sales 3 Years Time *
10. Estimated Market Size in 3 Years Time under US$500,000       US$500,000 - US$1M      
US$1M - US$2M       US$2M - US$10M      
more than US$10M      
11. Estimated Months to Profitability
12. Previous Round of Financing
Hold down the Shift key (Macintosh)
or the Control key (Windows)
to make Multiple Selections.
13. Total Amount Raised
14. How Much Do You Plan to Raise in Futher Rounds of Financing
15. Which of the Following Best Describe Your Company
Hold down the Shift key (Macintosh)
or the Control key (Windows)
to make Multiple Selections.
16. Has Your Company Received Government or Community Grants
( If Yes, please briefly describe.) 		Yes No
17. Has Your Company Received any Professional Assistance from the following
Hold down the Shift key (Macintosh)
or the Control key (Windows)
to make Multiple Selections.
18. Management Team
( Details of up to 5 team members )
( maximum 400 words)
19. Briefly describe major shareholders
(if not included in management team )
( maximum 100 words)
20. Please briefly describe up to three your major competitors
( maximum 100 words)
21. Please briefly describe your strategic alliance partners (if any)
( maximum 100 words)
22. What is the status of your business plan
23. What is the status of your products / services
24. Year found
25. Legal structure
(e.g. sole trader, partnership, limited partnership, limited proprietary company, unit trust, etc.)
26. Number of 'full-time equivalent' employees
27. Please briedfly describe the intellectual property rights owned by your company that will give your company competitive advantage
( maximum 100 words)
28. Please give up to 10 keywords that are most frequently used to describe your business
29. Brief summary
( maximum 400 words )
30. Detailed description
( maximum 1000 words )
 
31. Contact details  
  Name of person submitting this listing
  Contact person name *
(if different from above)
  Title
  Relationship with the listing firm
  Name of firm *
  Firm address
  City
  State / Province
  Country
  Zip / Postal Code
  Phone *
  Fax
  Email *
  URL
32. Permission to publish contact details
 

I authorize VCMP to post the following contact details of my company on the listing page.
(Please uncheck those you do not wish to be published).
Contact Name Firm Address Fax Number
Phone Number Email URL

 
33. Service and payment selection

( About the service options )
US$ 195 Investment opportunity listing for 12 months
34.

 Payment Options
Send credit card details online Send cheque

 
35. How did you find about us
36.

Please inform me of the new products/services offered by VCMP and its associates. Yes       No

37.

Subscribe to our free newsletter Yes       No

I guarantee the information provided is true and correct to the best of my knowledge and judgment and understand that I will responsible for any false and/or incorrect information submitted.

Yes                              No