Investor for AfriMatch- Investor Profile

1
Name* This field is required.
Prefix
First Name
Middle Name
Last Name
2
E-mail Address* This field is required.
example@example.com
3
What is your business title?* This field is required.
4
Business Phone Number* This field is required.Please share your business number where you would like to receive general information
Country Code
Area Code
Phone Number
5
Business Address* This field is required.
Street Address
Street Address Line 2
City
State
Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
6
Are you a black Investor?* This field is required.We are an organization for and by black people. We seek to provide black investors a place to invest with Africans on the continent and across the Diaspora.
YESNO
7
Do you own at least 51% of your black owned business?* This field is required.We work to match African Diasporan investors with African businesses and other Diasporan businesses around the world.
YESNO
8
NameIf you have a partner, please name them
First Name
Last Name
9
If you have a partner, please describe their role(s)?
Co-Founder
Chief Executive Officer
Chief Operating Officer
Chief Technology Officer
President
Director
Choose one
10
Are you a seasoned or first time investor?Choose "Yes" if you are a seasoned investor. Choose "No" if you are a first time investor.
YES, I am a seasoned investorNO, this is my first time
11
How much are you interested in investing?
Please Select
Please Select
Up to $5,000
$5,001 - $10,000
$10,001 - $25,000
$25,000 - $50,000
$50,001 - $100,000
$100,000 - $500,000
$500,000 - $1 Million
$1 Million Plus
12
Which do you prefer investing in a startup or growth company?Choose "Yes" if you are a seasoned investor. Choose "No" if you are a first time investor.
StartupGrowth
13
Which industry(ies) do you prefer to invest in?* This field is required.Choose as many options as you want (click on the option to add and then click in the box to choose additional industries.}
Please Select
Financial Services and Technology
Information Technology and Data
Film, TV, and Media
Education
Clean Energy and Eco-friendly Products/Services
Food and Beverage
Hotel, Hospitality, and Travel
Entertainment
Healthcare and Medical Technology
Real Estate and Architecture
Agriculture
Retail and E-Commerce
Transportation and Logistics
Nonprofit/Social Impact
Other
14
What is your website address?
15
What is your Linkedin handle?
16
What is your "X" (formerly Twitter) handle?
17
What is your business Facebook page name?
18
What is your Instagram handle?
19
I agree that the information herein are true and correct
Yes
20
Cell Phone (We'll send you texts for potential Investment Opportunities)* This field is required.Based upon your chosen industries and opportunities
Country Code
Area Code
Phone Number
21
Signature
Clear
Should be Empty: