Before filling in this application form to apply for entrance toInvestment Sharks Northwest, consider the following: We recommend you fill in this form from a desktop and in the Chrome Browser. Read through the questions first. If you prefer you may download a printable Application Form in PDF from this website. You can use this as a draft. If you have a scanner you can fill this form in and email it to firstname.lastname@example.org. You can also print off the PDF form and mail it to: Investment Sharks Northwest, Kirkland Chamber of Commerce, 440 Central Way, Kirkland, WA 98033. You are required to answer all questions on this online form. If you are unable to answer a question, or an answer is not applicable to you, include an expression such as ‘not applicable’. In the larger blocks of text, we have limited the number of characters you may type (or speak) to 350 characters or less. Allow 4 business days to confirm we have received your application. You can also call the office with any questions at 425-822-7066. Good Luck! Your Name Company Name Prior Name of Business, if any Entity Type: C Corp, S Corp, or LLC? Who Referred You? Industry - Check all that apply Green TechnologyConsumer ProductEnergySoftwarePharmaceutical / Medical DeviceReal EstateServicesFinancingBio / LifesciencesOthers- Specify Below Other Industry if applicable Company Address Founder/CEO Founder Title Office Phone xxx-xxx-xxxx Mobile/Cell Phone xxx-xxx-xxxx Date Founded Your Email Address Website Address Number of Full-Time Employees Number of Part-Time Employees WHAT IS YOUR.. COMPANY OVERVIEW PROBLEM/OPPORTUNITYExplain the problem you are solving and prove why it is an opportunity to that target audience. SOLUTIONExplain how to solve the problem and how to solve it differently from other BUSINESS MODELExplain your revenue source, sales cycle, and price of products/services TRACTIONTraction ideally is proved in terms of contract, patent, sales figure, etc. Interest from your customers is not considered traction EXECUTION PLANExplain your delivery of products/services to your customer step by step with specific dates MARKETProve the ‘addressable’ market that is actually reachable by your company within the next 3-5 years CUSTOMERSExplain the characteristics of the buyer and the end-users COMPETITIONList at least three direct/indirect competitors MANAGEMENT TEAMList name, title, and related experience that make your team qualified to run your company BOARD OF DIRECTORS / ADVISORSList names and backgrounds of Board of Directors and advisors FINANCIAL PROJECTIONS (Add a zero "0" or a dash '-' if not applicable) REVENUESWhat were your actual revenues for the years 2017 and 2018 REVENUESWhat are your forecast revenues for the years 2019, 2020, 2021 COGSWhat are your actual COGS for the years 2017 and 2018 COGSWhat are your forecast COGS for the years 2019, 2020, 2021 GROSS PROFITSWhat were your actual Gross Profits for the years 2017 and 2018 GROSS PROFITSWhat are your forecast Gross Profits for the years 2019, 2020, 2021 EXPENSESWhat were your actual Expenses for the years 2017 and 2018 EXPENSESWhat are your forecast Expenses for the years 2019, 2020, 2021 EBITDAWhat were your actual EBITDA for the years 2017 and 2018 EBITDAWhat are your forecast EBITDAs for the years 2019, 2020, 2021 Current Monthly Burn Rate INVESTMENT REQUIRED Pre-Money Valuation Asking Investment Range Proposed Terms EXIT STRATEGYProvide a Specific Date, Prepared Liquidation Price, and ROI RESOURCES NEEDED BEYOND CAPITALProvide any resources your company needs beyond capital: introductions, executive recruitment, etc. It is highly recommended to submit a video pitch (up to 3 minutes) with your application. We will accept your video pitch link from either Vimeo or YouTube. Enter the URL here: Click the box below I acknowledge, understand and accept the following: This application and event is for information and illustrative purposes only. It is not and should not be regarded as “investment advice” or as a “recommendation” regarding a course of action, including without limitation as those terms are used in any applicable law or regulations. This information is provided with the understanding that with respect to the material provided herein (i) Kirkland Chamber of Commerce is not acting in a fiduciary or advisory capacity under any contract, or any applicable law or regulation, (ii) the panel will make their own independent decisions with respect to any course of action in connection herewith, as to whether such course of action is appropriate or proper is based on your own judgment and your specific circumstances and objectives, (iii) presenters and panel are capable of understanding and assessing the merits of a course of action and evaluating investment risks independently, (iv) to the extent the presenters and panel shall be treated as an independent fiduciary for purposes of applicable regulation, Kirkland Chamber of Commerce does not purport to and does not, in any fashion, provide tax, accounting, actuarial, recordkeeping, legal, broker/dealer or any related services, and (v) any offers received during the event are contingent on further due diligence by the investor(s), and is not a guarantee that you will receive funding. You may not rely on the material contained herein. Kirkland Chamber of Commerce shall not have any liability for any damages of any kind whatsoever relating to this material.