International Venture Partners - Business Plan Questionnaire

Please provide general contact information on your company

Contact Person:
Business Name:
Street Address 1:
Street Address 2:
City:
State:
Zip:
Telephone Number:
Fax Number:
E-Mail Address:
How did you hear about International Venture Partners?
Who referred you to International Venture Partners?

Please help us classify your new venture
(place an "x" after the appropriate response under each question)

Type of Technology:
Healthcare/Bio-Technology:
Communications or Networking:
Computer Software:
Computer Hardware or Peripherals:
Consumer Product:
Internet related:
Service business:
Other (describe briefly):

Channel of distribution:
Direct Marketing
Direct Sales Force
Distributor/VAR/Manufacture's Rep:
Internet:
OEM:
Retail:
Other (describe briefly):

Customer Type:
Commercial or Business:
Consumer:
Education:
Government:
Industrial:
Other (describe briefly):

Functional area(s) most critical to business success:
Customer Service:
Engineering or Research and Development:
Manufacturing or Operations:
Marketing:
Sales:
Other (describe briefly):

Please provide the following information on your venture

Current Funding Round:
Pre-Money valuation:
Funding round goal($ you wish to raise):
Funding round anticipated closing date:

Anticipated Next Funding Round:
Expected date of next funding:
Expected amount of next funding:

Company Product or Service:
Description:
Benefit/Problem it solves:
Target Customer:
Competitive advantage:

Current Company Status
(place an "x" after the appropriate response)


Product Status:
Organizing:
Developing Product:
Beta Testing:
In Market/Some Revenue:
Other:

Legal Status:
Corporation:
Partnership:
Sole Proprietorship:
Other:

Man-Months invested to-date by Founders:

Current cash balance:

Current monthly revenues:

Current monthly burn rate (expenses):

Liquidity Plan and Expected Date (If by acquisition, list several likely candidates)

Will you provide The Angels Forum with a Board of Director's seat?	yes no maybe

Will you provide The Angels Forum with a monthly income statement and cash position by the 15th of the following month?	yes no OR date to begin:

Will you provide TAF with a quarterly balance sheet by the 20th of the month following the quarter end?	yes no OR date to begin