Name *

First Name

Last Name

Headquarters Legal Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Business Traction

What stage of development is your business?

Pre-revenue

Revenue positive

EBITDA positive

Form of Capital

Are you raising debt or equity?

Senior Debt

Subordinated Debt

Convertible Note

Convertible Preferred

Preferred

Common

SAFE

Warrants

Industry Sub-Sector

Please indicate which sub-sector best categorizes your business.

Beverages

Biosynthetics

Biotech

B2B

CBD

Clinics

CME (continuing medical education)

Commodities/trading

Compliance & regulatory

Concentrate

Cosmetic

Cultivation

Data analytics

Device

Distribution/logistics

DTC

Edibles

Enterprise software

Extraction

FinTech/payments

Flower

Genetics

GCO (global cannabis operator)

Inhalables

Inventory management

Lab/testing

Life sciences

Logistics

Marketplace

Manufacturing/processing

Media/content

MSO (multi-state operator)

Nanotechnology

Pharmaceuticals

POS systems

Retail

Seed sales

Selling/marketing

SSO (single state operator)

Supplements/vitamins

Tissue culture

Workforce/hiring