Borrower | Madison Branson Capital

Application for Funding

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Applicant Name*

First Last

Email*

Phone*

Postal Address*

Street Address City / Suburb State Postal Code

Applicant company trading name*

Company website URL

Which Madison Branson product or service are you looking for?*

Are you interested in receiving advisory services or establishing an advisory board?*

Receiving advisory services

Establishing an advisory board

Capital Raising & Investment

In which industry does your business/venture operate?*

Which investment stage is your company at?*

What problem is your company solving?*

What's the vision you have for the company?*

What traction / progress have you made so far towards this vision?*

What should we know about you and your team?*

What is your LinkedIn Profile URL?*

How much are you looking to raise?*

What investment instrument are you proposing?*

Valuation (pre-money) you are seeking (AUD $), if applicable (please skip if a valuation will not be determined e.g. SAFE note).*

Number of founders*

Number of team members*

Monthly revenue (AUD $)*

Current gross burn rate per month*

Have you raised capital prior to this round?

How did you hear about us?*

Specify Other*

Upload your pitch deck

Drop files here or

Max. file size: 25 MB.

Attach your files

Property Lending

Which best describes the need for your loan?*

At which stage is the development?

Which best describes your involvement in the project*

What is the location of your project?*

How much are you looking to borrow?*

Upload your project proposal, plan or prospectus

Planning documents (including planning permit and application)

Construction/building contract

Attach your files

Upload your file/s

Drop files here or

Max. file size: 25 MB.

Is the property subject to any lease?*

Please provide details of the term of the lease (including options), and the monthly rental (excluding GST) plus outgoings.*

Advisory Board

What industry is your business in?*

Have you commenced trading?*

Do you already have board members?*

Please provide their full names and the value they are providing as a board member?*

How many board members do you require?*

Do you require executive, or non-executive members?*

How do you need assistance from board members?*