NEW MEMBER APPLICATION Contact Info:Name* First Last Phone*Email* Home Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Business Details:Company NameWebsite What does your business do?*Desired date of occupancy?* Date Format: DD dot MM dot YYYY Last Year's Revenues:Pre-revenue$1 - $99,999$100,000 - $249,999$250,000 - $999,999$1,000,000+Have you ever willfully and intentionally refused to make payments when due?*YesNoDo you know of anything which may effect your ability to pay your monthly investment?*YesNoHave you ever been convicted of any crime?*YesNoHave you ever been evicted from any tenancy?*YesNoHave you ever filed a petition for bankruptcy?*YesNoIf so, when?*Is there any additional information about yourself or your business that you would like to share?Terms & ConditionsI hereby certify that the answers I have given in this application are true and correct to the best of my knowledge. I understand that any false answers or statements made by me will be sufficient grounds for termination of my membership.* I have read and agree to the Terms and Conditions