Contact Name

Contact Title

Address

City / State / Zip

Phone

Fax

Email

Website Address

Year Company Started

Type of Business

Industry

Number of Employees

Revenue - Last 12 Months

Projected First Year Annual Revenue (post funding)

Brief Description of business / products / services

(3 sentences or less)

Accomplishments to date

(3 sentences or less)

What is the customer problem that is solved?

(3 sentences or less)

How do you plan to make money?

(3 sentences or less)

Founder's Names & Background

(3 sentences or less)

Management Team / Significant players' names & backgrounds

(3 sentences or less)

List other companies that address the same need.

(3 sentences or less)

Market Size

Financing sought

Is there a term sheet in place for the current round? If so, who is the lead investor?

Uses of financing

(3 sentences or less)

Previous funding to date

Documents in place

List available investment documents (Executive Summary, PPM, etc.)

Proprietary technology / patents

Major obstacles to success

(3 sentences or less)

How did you hear about NCN?

Secret Code