First Name *

Last Name *

LinkedIn Profile URL *

Are you an Accredited Investor as defined by Rule 501 of Regulation D of the U.S. Securities and Exchange Commission (SEC)?
YesNo

Have you invested in Startups?
YesNo

Email Address *

Phone Number *

Do you live in Southern California and/or the surrounding area?
YesNo, but I spend at least half of my time in Southern CaliforniaNo, I almost never travel to Southern CaliforniaOther

How did you hear about TiE SoCal Angels
I know a member of TiE SoCal AngelsResearch onlineSocial MediaI currently do investments

Name of referring angel (If you know a current member, please provide her or his name)