Capital Provider Submission Form

State ^* (required)

Country ^* (required)

Company ^* (required)

Email ^* (required)

Capital Provider Type ^* (required)

Typical Initial Check Size ^* (required)

Maximum Total Commitment ^* (required)

Sector Focus ^* (required)

Basin - Domestic ^* (required)

Basin - International (for non-US ONLY)

Exploration Method ^* (required)

Investment Stage ^* (required)

Operating/Interest Preference ^* (required)

Capital/Investment Structure Offered ^* (required)

Acceptable Uses of Proceeds ^* (required)

Target Hold Period ^* (required)