Kerrisdale Capital Investor Registration

Personal Information

First Name:*

Last Name:*

Date of Birth (mm/dd/yyyy):*

Street Address:*

City:*

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Phone Number:*

Educational Background

Highest Educational Degree:*

Institution:

Year:

Employment

Current Employer:*

Title:

Address:

Years of Service:

Prior Employer:

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Address:

Years of Service:

Financial Information

Do you have an individual net worth, or joint net worth with your spouse, in excess of $5,000,000? As used herein, "net worth" means the excess of total assets at fair market value, including home furnishings and automobiles (but excluding the value of your primary residence), over total liabilities (excluding the indebtedness secured by your primary residence up to its fair market value). *

Do you have an individual net worth, or joint net worth with your spouse, in excess of $5,000,000? As used herein, "net worth" means the excess of total assets at fair market value, including home furnishings and automobiles (but excluding the value of your primary residence), over total liabilities (excluding the indebtedness secured by your primary residence up to its fair market value).*

Yes
No

Investment Experience

Have you ever invested in the following? Please check all that apply.

Domestic Stocks/Mutual Funds
Options, Commodities, Futures
International Stocks/Funds
Hedge Funds
Investment Partnerships
Borrowed money or used margin
Equity Derivatives
Other
Bonds or Bond Funds

How long have you been investing in any of the above instruments?

Less than 1 year
1-3 years
More than 3 years

To what extent do you follow the market?

Not at all
Somewhat
Very Closely

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Educational Background

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