Retail & Restaurant Growth Capital, L.P.

Complete the following form and we will send you additional information about working with RRGC.

Contact Information
Company Name:
Contact Person & Position:
Corporate Street Address:
City:
State:
ZIP Code:
Daytime Phone:
Fax:
E-mail:
Business Information
Type of Business:
Number of Stores:
Last Year Total Company Revenue ($):
Amount of Capital Required:
Comments

DISCLAIMER: YOU ARE SUBMITTING THIS INFORMATION FOR THE SOLE PURPOSE TO ASSIST RETAIL & RESTAURANT GROWTH CAPITAL, L.P. ("RRGC") WITH ITS INITIAL SCREENING PROCESS. YOUR SUBMISSION OF THIS INFORMATION IN NO WAY IMPLIES ANY COMMITMENT OR OBLIGATION ON THE PART OF RRGC TO PROVIDE ANY FINANCING WHATSOEVER TO YOUR COMPANY OR ANY OF ITS AFFILIATES. ANY FINANCING PROVIDED BY RRGC WILL COME ONLY AFTER A REVIEW OF YOUR COMPANY AND ITS BUSINESS AND FINANCIAL PLANS, PERSONAL MEETINGS WITH MEMBERS OF YOUR MANAGEMENT AND THE APPROPRIATE APPROVALS OF RRGC'S INTERNAL COMMITTEES.

BY SUBMITTING THIS INFORMATION ELECTRONICALLY THERE IS NO ASSURANCE IT WILL REMAIN CONFIDENTIAL. RRGC DISCLAIMS ANY WARRANTIES OR COVENANTS THAT MAY BE IMPLIED WITH RESPECT TO THE CONFIDENTIALITY OF THE INFORMATION SUBMITTED BY YOU AND SHALL NOT BE LIABLE TO YOU IF SUCH INFORMATION FAILS TO BE CONFIDENTIAL. FORMAL CONFIDENTIALLY AGREEMENTS CAN BE NEGOTIATED AFTER A MORE THOROUGH CONVERSATION WITH RRGC.