Institutional Investor – Equity Profile

Please complete the short Equity Profile that follows and a professional associate will contact you if you are not already assigned to a Consultant.

The information you are about to enter is being done through a Site Secured License or SSL Certified by McAfee and domicile is a secure database too. Accordingly, please be sure to complete all required fields that have an asterisk [*] so we know how best to match and meet some of your investment goals.

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I. GENERAL BACKGROUND INFORMATION

(1) Contact Information

First Name *

Last Name *

Company *

Title *

Email *

Mobile or Phone 1 *

Mobile or Phone 2

Fax

Street *

City *

State/Province *

Zip *

Country *

Website

(2) Preferred Correspondence Address, Select One *

(3) Alternate Contact (If different from you.)

(4) YOUR PRIMARY CONSULTANT *

Were you referred to International Partners by one of our Consultants?

(5) How Did You Hear About Us? *

Please select one or all that apply. You may control-click (Windows) or command-click (Mac) to select more than one.

Please enter comments from previous question if required.

II. EQUITY SOURCE, SIZE & STRUCTURE

(1) Select Type of Equity *

(2) Typical Size of Equity Placement (in millions) *

(3) Types of Equity Placements? *

Hold down ‘Ctrl’ key to make multiple selections.

(4) Typical Equity Structure in Deal? *

III. MARKETS FOR EQUITY INVESTMENT *

Top 4 Markets in the US by percentage.

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* These fields are required.