Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

My Individual Net Worth exceeds $2.1M? *

Yes

No

Cash Flow or Liquidity Needs

Low

Medium

High

Risk Tolerance *

Low

Medium

High

Investment Time Horizon *

Short Term (less than a year)

Long Term (greater than a year)

Investment Experience *

Novice

Intermediate

Expert

Do you hold interest in other hedge funds? *

Yes

No