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
Website
Year Founded
Instagram
Number of Full-Time Employees (W2)
Number of Contractors (1099)
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:
City of Operation
County of Operation
Please select...
Alameda
Contra Costa
Marin
Napa
San Francisco
San Mateo
Santa Clara
Solano
Sonoma
Other
Please specify County:
INQUIRY INFO
How will you use this capital?
Be specific: equipment, hiring, working capital, inventory, expansion, etc
Capital Need Timeline
Please select...
0-3 Months
3-6 Months
6-9 Months
9-12 Months
Annual Revenue
Pre-Money Valuation (if applicable)
Capital Amount Requested
Please select...
Under $50K
$50K - $100K
$150K- $500K
$500K-$1M
$1M-$2M
Over $2M
Prior Investors
No Prior Investment / Self-Funded
Friends & Family
Crowdfunding
Angel Investors
VC's / Institutions
ICA Fund
Pitch Deck / Data Room
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
Technical Assistance Organization
The Alliance for Community Development
Event
Other
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Contact Information