Professional AfriMatch- Professional 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
Business Phone Number* This field is required.
Area Code
Phone Number
4
Cell Phone (We'll send you texts for potential match opportunities)* This field is required.Based upon your chosen industries and opportunities
Country Code
Area Code
Phone Number
5
What is the Name of your business?* This field is required.
6
What is your business title?* This field is required.
7
How do you prefer to communicate?Choose which convenience for communication you prefer.
EmailPhone/Txt
8
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
9
Are you a black or black-African owned business?* This field is required.We are an organization for and by black people. We seek to match Diasporan and African entrepreneurs together to start and grow businesses on the continent and we seek to provide black investors a place to invest with Africans on the continent and across the Diaspora.
YESNO
10
Do you own at least 51% of your black-owned business?* This field is required.We work to match African Diasporan businesses with African businesses and Diasporan investors around the world.
YESNO
11
What is your industry?
12
Describe your business (add fields as needed)
13
If you have a partner, please name them and describe their role(s)?
Co-Founder
Chief Executive Officer
Chief Operating Officer
Chief Technology Officer
President
Director
Choose one
14
Is your business registered in your jurisdiction?* This field is required.We work to match African Diasporan investors with African businesses and other Diasporan businesses around the world.
YESNO
15
Tell us your fee structure.Ex, we provide a three-tier program - Tier "a" includes and = $", Tier "b"=$, "c=$"...
16
What is the average gross revenues your company generate annually?
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
17
What is your website address?
18
What is your Twitter handle?
19
What is your Linkedin handle?
20
What is your Facebook name? (Add your business page if you have one)
21
What is your Instagram handle?
22
Signature
Clear
23
I agree that the information herein is true and correct.
Yes
24
Please upload a current photo, OR a driver's license, state or national ID, or passport (you need only one of these)You must be of African descent to join our membership.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
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