.

1

What best describes your profile?* This field is required.

Business Owner

Have a Project to Finance

2

Where is it based?* This field is required.

US

EU

Other

3

Sector* This field is required.

Telecom

Alternative Energy

4

Which Specific Area?* This field is required.choose only one option *

Telecom Sector

Alternative Energy Sector

5

Describe your Main Services or Products. max 3 sentences* This field is required.examples : * “We provide high-speed internet solutions ..."

8

Do you have a Qualified Pipeline?* This field is required.

YESNO

10

Are you a full or part owner of the company and Can you decide how to allocate equity?* This field is required.

YESNO

12

What is your biggest challenge? max. 3 sentences* This field is required. example : * “Seek funding, project or expansion ...”

13

Do you want us to consider your company to become a portfolio company?* This field is required.

YESNO

14

Contact Information* This field is required.

First Name

Last Name

Company Name

Company URL

Email

Country

Phone Number

15

Is your business making a community contribution? * This field is required.

YESNO

16

Are you practicing Anti-corruption measures and financial transparency?* This field is required.

YESNO

17

Are you practicing Responsible Sourcing in supply chain?* This field is required.

YESNO