Legal Disclaimer -
I understand that Private Equity Match (“PEM”) has made no factual investigation into any of the proposed ventures, that PEM is making no recommendations regarding any such investments, that any decision to invest will be mine alone, based upon private discussions between myself, my advisors and the entrepreneur and I agree to release and hold PEM, its agents, and/or employees harmless against any action, claim, demand, or damage suffered as a result of engaging in any transaction including by reason of the inaccuracy or incompleteness of any information provided to me.
Acceptance required. I Accept

I understand that any discussions that I might have regarding possible investments will be based upon private discussions between me and specific entrepreneurs and not as a result of any advertisement or public solicitation.
Please make a selection.Acceptance required. I Accept.

Please check all geographic regions in which you would consider investing:
Anywhere in the US
Northeast Region
Mid-Atlantic Region
Southeast Region
Midwest Region
Southwest Region
California Region
Northwest Region
NA AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY Select Individual State
Outside of the US

Please check the business or industry categories of interest to you. You may check as many as you want.
Aerospace & Defense
Agribusiness / Fishing / Forestry
Biomedical / Biotech
Computer Hardware / Peripherals
Computer Software
Consumer Electronics
Distribution / Wholesale Trade
Education
Energy / Natural Resources
Entertainment / Multi-Media
Environmental
Financial Services
Healthcare Services
Internet
Manufacturing – Consumer Products
Manufacturing – Industrial Products
Publishing / Printing
Real Estate / Construction
Recreation / Recreation Products
Retail
Services – Other
Telecommunications
Transportation

Please indicate which type(s) of ventures are of interest to you. You may check as many as you want.
Seed: A venture in the idea stage or in the process of being organized.
Research & Development: Product development for early stage or more developed companies.
Start-up: Completing product development and initial marketing, and in business less than two years.
First Stage: Working prototype, which has gone through beta testing and is beginning commercialization.
Expansion Stage: Expanding commercialization and is in need of growth capital.
Mezzanine: Increasing sales volume and is breaking even or is profitable. Funds are to be used for further expansion, marketing or working capital.
Bridge: Requires short-term capital to reach a clearly defined and stable position.
Acquisition/Mergers: Capital needed to finance an acquisition or merger.
Turnaround: Capital is needed to effect a change from unprofitability to profitability.

Total Capital Available or Under Management: $

8. What investment levels are you comfortable making?
Up to $50,000
$50,001 to $100,000
$100,001 to $250,000
$250,001 to $500,000
$500,001 to $1 million
$1,000,001 to $5 million
$5,000,001 to $10 million
Above $10 million

(As previously mentioned, there is a small annual fee of $99.00, which helps to eliminate non-serious investors while helping to offset a small portion of our administrative expenses).