1.How much money are you raising? (£)

2.Does your company have shares other than ordinary shares?

Yes

No

3.Are you looking to issue shares other than ordinary shares?

Yes

No

4.What is the company name?

5.What is the company's registered address?

6.Do you have a website and if so what is the url?

7.In less than 100 words can you describe what your company does or will do?

8.Who are the founders of the company?

9.Are there other existing shareholders? If so, who are they?

10.Have you got investors lined up already? If so, who are they?

11.What's your email address please?

12.What's your phone number?