Company*
Address*
Date Founded*
No of Full Time Team members
No of Part Time Team members
Presenter*
Title*
Office Phone*
Cell Phone*
Email*
Web Site
Last Update

* Please limit your responses to 500 characters or less for each section.
* Feel free to delete italicized notes below each section to keep it clean.


Company Overview
Problem/Opportunity
Solution
Business Model
Traction
Execution Plan
Market
Customers
Competition & Barriers to Entry
Management Team
Ownership
Board of Directors
Advisors

Title	2015 Actual	2016 Actual Forecast	2017 Forecast	2018 Forecast	2019 Forecast
Revenue
COGS
Gross Profit
Expenses
EBITDA

Current monthly burn rate:
Please Indicate Duration of Financial Year:
Please Indicate the Currency:

Series	Date	Source	$ Amount	Class of equity	% of equity	# of shares outstanding	Post-money valuation

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Investment Required *
Asking Investment Range *
Need from Keiretsu Forum *
Proposed terms *
Pre-Money Valuation *
Please Indicate the Currency:
Use of Investment(Use the format below)
Category	Use	Amount
Total
Exit Strategy
Please Indicate the Currency:
Resources needed beyond capital