Club Application - Capitellio

Your Name

Phone Number

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Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

How did you hear about us? (Select all that apply)

Referred by a friend/colleague

Event

Link from another website

Article

Google/Search

Podcast

Facebook

YouTube

Other

Who referred you?

Which Website?

What were you searching for?

Name and City of Event

Name of Publication and Title of Article

Which Podcast?

What other source?

Do you invest as an individual or on behalf of a company? Note: If you invest with a single-member LLC for which you are the owner, or an LLC that only includes you and your spouse, choose "Individual.")

Individual

Company

Please select the category that best applies to you:

I have an individual net worth, or joint net worth with my spouse, of more than $1,000,000, excluding my primary residence

In each of the last two years, I have individual income in excess of $200,000 OR joint income with my spouse in excess of $300,000 and reasonably expect to reach that income level again this year

Neither of the above

What's the name of your company?

Please select the category that best applies to the entity:

A corporation, partnership, business trust, or non-profit organization within the meaning of Section 501(c)(3) of the Internal Revenue Code, with total assets in excess of Five Million Dollars ($5,000,000)

A trust with total assets in excess of Five Million Dollars ($5,000,000), where the purchase is directed by a "sophisticated person" as defined in Regulation 506(b)(2)(ii)

An entity in which all the equity owners are "Accredited Investors"

None of the above

Have you had any of the following investment experience?

Trading individual stocks for at least two years

Real estate investing for at least two years

Bond trading for at least two years

Mutual Funds

Cryptocurrencies or Foreign Exchange

None of the above

What kind of real estate investing have you done in the past?

Fix and Flip

Rentals (single family up to four units)

Multifamily (five units or more)

Private Lending

Tax Deeds or other paper instruments

Self Storage

Assisted Living

How important are these to you? (Scale: 1 = Not Important, 5 = Very Important)

	1	2	3	4	5
Cash Flow
Total Return
Safety of Principal
Tax Benefits

Are you someone who looks for high risk / high return deals, or are your goals more conservative and gradual?

High Risk / High Return

Conservative Growth

Do you feel that a deal's success should be judged by profit alone, or are there things you look for beyond the bottom line in an investment offering?

Profit alone

Other factors are important to me

What would you do with Passive Income?

Reduce or Replace your Work Hours

Build a Travel Fund

Support a Passion Project

Defray your Living Costs

Save for Retirement

Pay for your Child's Education

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