Investor Application
Please fill out this form to apply for membership in the Headwaters Angel Network. This information helps us to understand your investment goals and prioritize the most attractive investment opportunities. 
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Name  *
Phone Number *
Address *
What is your connection to the Mississippi Headwaters region? *
Are you an accredited investor? *
Why do you want to join? *
Describe the types of companies or deals you are most interested in.
If presented with attractive investment opportunities, how much do you intend to invest per year and per deal?
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