Global Investor Partnership Registration Form

 
Date: Title/Position: 
   
   
Company: Phone & Extension:
 
   
Contact:  Cell: Email Address: 
    
   
Address:  Web Site Address: 
   
Address 2:   Emergency Contact:
   
City/Town:  Country: 
   
State/Province/Prefecture:   
 
   
PO Box Address:    
 
   
INVESTMENT CATEGORY-A                     
Joint-Venture Co-Development Profit-Sharing Arrangement
 INVESTMENT CATEGORY-B
Strategic Alliance Barter Arrangement Co-Management Participation
   
INVESTMENT CATEGORY-C 
12-Month Loan 24-Month Loan 36-Month Loan