ICA Fund Investment Partnership Form
CONTACT INFO
First Name
Last Name
Title
Linkedin URL
E-mail
Preferred Phone #
COMPANY INFO
Company Name
Brief Description of Business
2-3 sentences on what you do and who you serve
Year Founded
Year you started operating
Company Website
Primary Social Handle
Instagram or TikTok handle you're most active on
Number of Full-Time Employees (W2)
Count yourself if you work full-time in the business
Number of Contractors (1099)
Regular 1099 contractors
Legal Structure
Please select...
Benefit Corporation
C-Corp
LLC
Partnership
S-Corp
Sole Proprietorship
Other
Industry
Please select...
Advanced Manufacturing
Agriculture
Apparel
Architecture
Bars, Restaurants, Catering
Beauty & Personal Care
Business Services
Construction
Distribution & Logistics
Education
Energy
Engineering
Environmental
Financial Services
Food and Beverage - CPG
Food and Beverage - Food Service
Healthcare
Hospitality
Insurance
Manufacturing
Marketing & Communications
Multimedia & Publishing
Other
Personal Services
Real Estate
Retail
Technology
Transportation
Travel & Aviation
Utilities
Please specify Industry:
Business Headquarters
County of Operation
Please select...
Alameda
Contra Costa
Marin
Napa
San Francisco
San Mateo
Santa Clara
Solano
Sonoma
Other
Please specify County:
INQUIRY INFO
Capital Amount Requested
Please select...
Under $50K
$50K - $100K
$150K- $500K
$500K-$1M
$1M-$2M
Over $2M
How will you use this capital?
Be specific: equipment, hiring, working capital, inventory, expansion, etc
Annual Revenue
Last 12 months of revenue
Total Prior Capital Raised (approximate)
Please select...
$0
Under $25K
$25K-$100K
$100K-$500K
$500K-$1M
$1M-$5M
Prior Investors
No Prior Investment / Self-Funded
Friends & Family
Crowdfunding
Angel Investors
VC's / Institutions
ICA Fund
Pitch Deck / Data Room/ Any Company Materials
How did you find out about us?
ICA Entrepreneur/Alumni
ICA Staff Member
ICA Advisor/Facilitator
ICA Email/Newsletter
ICA Website
Social Media
Bank
Microlender
CDFI Lender
Technical Assistance Organization
Event
Other
Anything else we should know?
Anything that would help help us route your inquiry
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Contact Information