Please provide the following contact information:

First Name
Last Name
Title
Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
FAX
E-mail
URL
	Are you an accredited investor?*
	Yes	No
	*You must be an accredited investor to receive information or join our network of investors.
	I would like to receive investor information
	Yes	No
	I am interested in becoming a member of TradeWind Ventures Investor Network*
	Yes	No
	*Membership is by invitation only A separate application will be sent to the email address provided above.
	Are you interested in Equity Investments?
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	Do you have Industry/Sector preferences?
	Do you have geographical preferences?
	Do you wish to participate in management?
	Yes	No
	Would you like a position on the board?
	Yes	No
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