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About
Media
Select Issuers
Fractional Issuers
Raise Capital
About
Media
Menu
About
Media
Select Issuers
Fractional Issuers
Raise Capital
Apply For DalmoreDirect
First Name
*
Last Name
*
Title
Email Address
*
Phone
*
Company Legal Name
*
State of Incorporation
*
Type of Company
*
Website
*
Country
*
Business Address 1
*
Business City
*
Business State
*
ZIP Code
*
Are you affiliated with any other business entity? For example, do the controlling owners also control other companies?
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Yes
No
Name of affiliated entities & details
*
Have you ever merged with, or been merged into another company? Give full name of the non-surviving company that was merged.
*
Yes
No
Name of non-surviving entity
*
Is the company a common subsidiary of another entity?
*
Yes
No
Name of parent entity
*
Does the company have any subsidiaries?
*
Yes
No
Name(s) of subsidiaries
*
Has the company ever been through bankruptcy?
*
Yes
No
Please select all relevant offering types you wish to pursue
Reg A
Reg CF
Reg D
How much do you intend to raise in your offering?
*
USD
Up to $5,000,000.00 as allowed by Reg CF
Will this offering be done concurrently with any other capital raising (such as an offering to accredited investors)?
*
Yes
No
Does the concurrent capital raising include terms or pricing that differs from the current offering?
Yes
No
If yes, please explain:
What type of securities are you offering?
*
Please Select
Common Stock
Debt
SAFE
Convertible Note
Preferred Stock
Membership Units
Others (please specify)
Other type of securities offered:
I agree to Dalmore Group/Dalmore Direct's
privacy policy.
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