Impact Angel Group Impact Assessment

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Dear Impact Angel Group Prospective Investee,

Thank you so much for your interest in applying for funding from the Impact Angel Group. The following is intended to help us better understand the social and environmental impact of your business.

PLEASE NOTE THE FOLLOWING:

1) Since we recognize that the impact of your early stage company may be very different in the future as it is today, we have asked you to answer these questions from the current and future perspective. FUTURE is defined as the earlier of 10 years from today or the projected time for investor exit.
2) Because we want to be respectful of entrepreneurs' time, many of these questions are not required. Required questions are indicated with a red asterisk. Please do not feel obligated to answer all of the optional questions. however, if we do decide to fund your company, we may require the answers to some of the optional questions prior to making an investment.
3) We understand that it is hard to predict the future, so please give your best estimate. We expect these estimates to change over time, but would like to have a ballpark figure.
4) Lastly, please answer these questions honestly. Honesty is perhaps our most important investment criteria.

1. Survey Respondent Information:
2. Enterprise Model Impact: Does your company have any of the following enterprise models? Select from the following socially- and environmentally-focused enterprise models that describe the specific problem your company attempts to solve. *This question is required.
4. Current Local Impact: Please indicate which of the following statements are true. *This question is required.
5. FUTURE Local Impact: Please indicate which of the following statements you expect to be true in the FUTURE. *This question is required.
6. Current Workforce Impact: Please answer with whole numeric numbers without punctuation or symbols (i.e.: 1, 10, 100, 1000, 10000, 100000) *This question is required.
7. FUTURE Workforce Impact: Please answer with whole numeric numbers without punctuation or symbols (i.e.: 1, 10, 100, 1000, 10000, 100000) *This question is required.
8. Current Local Workforce Impact: Please answer with whole numeric numbers without punctuation or symbols (i.e.: 1% = 1, 10% = 10). If not applicable, write NA. *This question is required.
9. FUTURE Local Workforce Impact: Please answer with whole numeric numbers without punctuation or symbols (i.e.: 1% = 1, 10% = 10). If not applicable, write NA. *This question is required.
10. Current Employee Wage Information: Please answer with whole numeric numbers without punctuation or symbols (i.e.: 1, 10, 100, 1000, 10000, 100000). If not applicable, write NA.
11. FUTURE Employee Wage Information: Please answer with whole numeric numbers without punctuation or symbols (i.e.: 1, 10, 100, 1000, 10000, 100000). If not applicable, write NA.
12. Current Social Impact: Please indicate which statements are true.
13. FUTURE Social Impact: Please indicate which statements will be true.
15. Current Environmental Impact: Please indicate which statements are true:
16. FUTURE Environmental Impact: Please indicate which statements are true: