Legal Name

First Name

Last Name

Preferred Name

Company Name

Phone

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How did you find out about the MIC Syndicate?

We value any and all of the referrals that strengthen our community, so please help us give credit where credit is due.

Are you an Accredited Investor or a Qualified Purchaser according to the most recent SEC guidelines?

To qualify as an Accredited Investor, an individual must meet at least one of the following requirements: Earned income exceeding $200,000 (or $300,000 together with a spouse or spousal equivalent) in each of the two most recent years, with a reasonable expectation of maintaining the same income level in the current year Net worth over $1 million, either individually or jointly with a spouse or spousal equivalent, excluding the value of the primary residence Hold in good standing a Series 7, Series 65, or Series 82 license A Qualified Purchaser is an individual or entity with $5M+ of net assets

Yes, I'm an Accredited Investor

Yes, I'm a Qualified Purchaser

No, I'm unable to participate in the Syndicate at this time

As a Member of the MIC Investor Syndicate, you agree to the following:

Confidential Information: You agree to receive information on the investment opportunities MIC is investing in, which includes due diligence information on companies seeking investment. You agree to keep all information you receive from MIC confidential. Members shall not share information they received from MIC with other individuals, funds, companies, or groups outside of MIC's Investor Syndicate unless the Member has received specific approval from MIC's General Partner, John Rozelle, to do so and the receiving party has specifically confirmed their adherence to this Membership Agreement prior to receipt of materials. Non-Circumvention: You will invest only through MIC's Investor Syndicate in opportunities that you receive from MIC's Investor Syndicate. Information a Member receives from MIC is only to be used by individual angels, groups of angels, and family offices who have the intention of investing personally or as an entity through MIC's Investor Syndicate. Members agree to invest solely through MIC's Investor Syndicate if it is an investment opportunity that they have received from MIC's Investor Syndicate. The information a Member receives is not to be used by investment managers seeking deal flow for their own funds to make direct investments outside of investing through MIC's Investor Syndicate. No Re-Syndication: Members shall not syndicate the same opportunity (or a derivative thereof) on any other platform or with any other group without the approval of MIC's General Partner, John Rozelle. Members shall not seek a direct or indirect allocations in companies or opportunities after being provided with information about such investment opportunities by MIC's Investor Syndicate, which would circumvent, compete, or otherwise affect MIC's investment allocation. Commitments Are Commitments: If a Member submits an investment commitment for an investment opportunity they agree to wire the amount of capital submitted and to sign the corresponding subscription documents. Decorum: Members will be removed from MIC's Investor Syndicate if they contravent any of the 4 principles above. Fees: Members agree to pay a 2% annual management fee for 10 years, which is collected upfront and drawn down over the investment holding period. Members agree to pay a 20% carried interest on profits. If the terms are different from above, they will be disclosed as part of the specific investment opportunity in which the Member invests.

I Agree