Home
About
Invest Now
Qualified Plans
The Team
The Micro’s
Investor Relations
Home
About
Invest Now
Qualified Plans
The Team
The Micro’s
Investor Relations
Contact Us
Invest Now Form
"
*
" indicates required fields
Name
*
First
Last
Address
*
Street Address
City
State
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Telephone
*
Secondary
Email
*
Is the address above your primary residence?
*
Yes
No
Primary residence address
Street Address
City
State
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Occupation
*
Please Select
Employed
Business owner
Retired
Other
Educational background
*
Please Select
High school
Some college
Associates degree
Bachelors degree
Masters degree
Doctorate
Other
Approximate Net Worth (Excluding Primary Residence)
*
Please Select
$5,000,000 or more
$1,000,000-$5,000,000
Less than $1,000,000
Gross income for each of the last 2 years
*
Please Select
$300,000 or more
$200,000 - $300,000
Less than $200,000
If married, is this income amount combined with that of your spouse?
*
Yes
No
Not Married
What is your combined gross income for each of the last 2 years?
*
Please Select
$300,000 or more
$200,000-$300,000
Less than $200,000
Over the next 2 years do you expect your income to
*
Increase
Decrease
Stay the same
In connection with my investment activities, I utilize the services of the following attorney, accountant or other advisor to assist me in analyzing investment opportunities (insert N/A if not applicable)
Name of Advisor
*
Position or Occupation
*
Business Address
Address
City
State
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Age
*
Please Select
21 - 30
31 - 40
41 - 50
51 - 60
61 - 70
71+
Marital Status
*
Please Select
Single
Married
Divorced
Widow
Prefer not to say
Number of dependents
*
Please Select
0
1
2
3
4
5
6
7
8
9
10
I believe I am an "accredited investor" as defined in Rule 501(a) of Securities and Exchange Commission Regulation D
*
Yes
No
I have adequate means of providing my current needs, and possible personal contingencies, and will have no need for liquidity in an investment in Cloud Nine
*
Yes
No
I have specific knowledge and experience in related financial and business matters so as to be capable of evaluating the relative economic and operational merits and risks of an investment in Cloud Nine
*
Yes
No
I certify that I have answered the foregoing questions to the best of my knowledge and that my answers hereto are complete and accurate
*
Yes
No
Name
This field is for validation purposes and should be left unchanged.
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About
Invest Now
Qualified Plans
The Team
The Micro’s
Investor Relations
Contact Us
