Fill and Sign the Creating Your Own Angel Investor Group Kauffman Foundation Form

Angel Investor Agreement _________________________(Name of Angel Network)____________________________________________________________________(Address of Angel Network)The _______________________ (Name of Network) Angel Network, hereinafter sometimes referred to as the Network , facilitates the introduction of entrepreneurs to potential investors through presentations and other mechanisms. As a Network Investor, I agree that I am:[ ] An accredited investor, as defined by the Securities Act of 1933, as amended, i.e., a natural person whose individual net worth, or joint net worth with that person’s spouse at the time of her purchase exceeds $1,000,000; or a natural person who had an individual income in excess of $200,000 in each of the two most recent years or joint income with that person’s spouse in excess of $300,000 in each of those years and who reasonably expects to reach the same income level in the current year; or[ ] A sophisticated investor, i.e., a person who does not meet the net worth or income criteria of an accredited investor, but has sufficient knowledge and experience in financial and business matters to be capable of evaluating the merits and risks of investment in restricted securities of a private enterprise.It is understood that Network is not a venture fund, an investment bank, a broker dealer, investment clearing-house, nor an investment advisor, but rather a forum in which angel investors may be educated on aspects of investment and business, as well as introduced to and informed of companies for possible investment. ________________ (Name of Network) is not registered with the Securities Exchange Commission or any state securities commission.All investments in entrepreneurial companies will involve a high degree of risk and investors should be able to bear the risk of complete financial loss. The choice to use and manner of utilization of information and knowledge gained through Network is each angel investor’s individual and personal choice. No guidance shall be given, nor shall any person affiliated with Network (or Network itself) be responsible for an individual angel investor’s use of the information, investment decision or the results of any investment. Network does not conduct any investigation to verify the factual information submitted to potential investors by individual entrepreneurs. Hence, Network makes no representations or warranties regarding these companies. Investors must conduct their own due diligence and negotiate the terms of investment they elect to make. Your signature represents an agreement that as an Angel Investor of _____________________ (Name of Network), you will abide by and uphold the guiding principles of the organization. It is understood that being a _________________ (Name of Network) Angel investor is confidential, and that your name will not be disclosed for any reason, and accordingly you will not disclose the names of other ________________________ (Name of Network) Investors.WITNESS my signature on the _____ day of _____________, 20_____. _________________________ (Printed Name of Investor) _________________________ (Signature of Investor) Print Name: ________________________________________ Phone:___________________________________Address: ________________________________________Email: ________________________________________Company Name:________________________________Sponsor’s Name: ____________________________________________Check appropriate box:[ ]New WINGS Angel Investor[ ] Renewing WINGS Angel investorPlease submit completed the ____________________ (Name of Network) Angel Investor Agreement with annual dues of $500.00. Please make check payable to ______________________ (Name of Network) or fill in the Credit Card information below for payment.Payment: ___________________# _________________Exp. Date________ (Name of Card)