Capital Raise Assessment Form          

Entrepreneur & Company Details

Number of staff (Please type 0 if not applicable).
No. of Male No. of Female
Fulltime staff
Part-time staff

Business Registration

Details of directors (including shareholding).
   Name of Director  Percentage Shareholding
Director 1
Director 2 
Director 3
Director 4
Director 5

Financial Snapshot 
Please provide annual revenues for the past 3 years, beginning from the previous year but excluding the current year (eg. Year 1 - 2020, Year 2 - 2019, Year 3 - 2018). (Put 0 if not applicable)
Year 1
Year 2
Year 3
3-Year Revenues

Capital Raise Requirements

B. Business Assessment Questionnaire

Key Management Team
Educational Background Years of Experience Roles & Responsibilities
CEO/Lead Entrepreneur
Operations Manager
Finance Manager
Marketing Manager
HR Manager
Chief Technology Officer
Business Development Manager

Products and Services

Market Size


Growth Strategy

Key Business Drivers

Key Assets

Major Customers

C. Key Information Availability Checklist

Business Operations
Yes No

Business Registration 
Yes No
Year-to-date Financials (Unaudited)
Yes No

Audited financial statements (3 years)
Yes No

Accounting & Bookkeeping
Yes No

Sales and Revenue Forecasts
Yes No