{"id":1561,"date":"2023-03-20T16:26:56","date_gmt":"2023-03-20T20:26:56","guid":{"rendered":"https:\/\/research.ncsu.edu\/win\/?page_id=1561"},"modified":"2023-06-06T12:01:29","modified_gmt":"2023-06-06T16:01:29","slug":"become-a-member","status":"publish","type":"page","link":"https:\/\/research.ncsu.edu\/win\/become-a-member\/","title":{"rendered":"Become a Member"},"content":{"rendered":"<script type=\"text\/javascript\">var 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);--gf-ctrl-size: var(--gf-ctrl-size-lg);--gf-ctrl-label-color-primary: var( --custom-background10 );--gf-ctrl-label-color-secondary: var( --custom-background10 );--gf-ctrl-choice-size: var(--gf-ctrl-choice-size-lg);--gf-ctrl-checkbox-check-size: var(--gf-ctrl-checkbox-check-size-lg);--gf-ctrl-radio-check-size: var(--gf-ctrl-radio-check-size-lg);--gf-ctrl-btn-font-size: var(--gf-ctrl-btn-font-size-lg);--gf-ctrl-btn-padding-x: var(--gf-ctrl-btn-padding-x-lg);--gf-ctrl-btn-size: var(--gf-ctrl-btn-size-lg);--gf-ctrl-btn-border-color-secondary: var( --custom-background9 );--gf-ctrl-file-btn-bg-color-hover: #EBEBEB;--gf-field-pg-steps-number-color: rgba(0, 0, 0, 0.8);}<\/style><div id='gf_3' class='gform_anchor' tabindex='-1'><\/div>\n                        <div class='gform_heading'>\n                            <h2 class=\"gform_title\">WIN Member Application<\/h2>\n                            <p class='gform_description'><\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_3'  action='\/win\/wp-json\/wp\/v2\/pages\/1561\/#gf_3' data-formid='3' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_3' class='gform_fields top_label form_sublabel_above description_below validation_below'><fieldset id=\"field_3_1\" class=\"gfield gfield--type-name gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_3_1\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Your Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_3_1'>\n                            \n                            <span id='input_3_1_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <label for='input_3_1_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                    <input type='text' name='input_1.3' id='input_3_1_3' value=''   aria-required='true'    autocomplete=\"given-name\" \/>\n                                                <\/span>\n                            \n                            <span id='input_3_1_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                            <label for='input_3_1_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                            <input type='text' name='input_1.6' id='input_3_1_6' value=''   aria-required='true'    autocomplete=\"family-name\" \/>\n                                                        <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_3_2\" class=\"gfield gfield--type-email gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_3_2\" ><label class='gfield_label gform-field-label' for='input_3_2'>Your Email Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_2' id='input_3_2' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><fieldset id=\"field_3_4\" class=\"gfield gfield--type-address field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_3_4\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Your Address<\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip has_country ginput_container_address gform-grid-row' id='input_3_4' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_3_4_1_container' >\n                                        <label for='input_3_4_1' id='input_3_4_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                        <input type='text' name='input_4.1' id='input_3_4_1' value=''    aria-required='false'   autocomplete=\"address-line1\" \/>\n                                   <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_3_4_2_container' >\n                                        <label for='input_3_4_2' id='input_3_4_2_label' class='gform-field-label gform-field-label--type-sub '>Address Line 2<\/label>\n                                        <input type='text' name='input_4.2' id='input_3_4_2' value=''    autocomplete=\"address-line2\" aria-required='false'   \/>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_3_4_3_container' >\n                                    <label for='input_3_4_3' id='input_3_4_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                    <input type='text' name='input_4.3' id='input_3_4_3' value=''    aria-required='false'   autocomplete=\"address-level2\" \/>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_3_4_4_container' >\n                                        <label for='input_3_4_4' id='input_3_4_4_label' class='gform-field-label gform-field-label--type-sub '>State<\/label>\n                                        <select name='input_4.4' id='input_3_4_4'     aria-required='false'   autocomplete=\"address-level1\" ><option value='' selected='selected'><\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='American Samoa' >American Samoa<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >Florida<\/option><option value='Georgia' >Georgia<\/option><option value='Guam' >Guam<\/option><option value='Hawaii' >Hawaii<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='Indiana' >Indiana<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='Kentucky' >Kentucky<\/option><option value='Louisiana' >Louisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >Michigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Mississippi<\/option><option value='Missouri' >Missouri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >New Hampshire<\/option><option value='New Jersey' >New Jersey<\/option><option value='New Mexico' >New Mexico<\/option><option value='New York' >New York<\/option><option value='North Carolina' >North Carolina<\/option><option value='North Dakota' >North Dakota<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >South Carolina<\/option><option value='South Dakota' >South Dakota<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='U.S. Virgin Islands' >U.S. Virgin Islands<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='Armed Forces Americas' >Armed Forces Americas<\/option><option value='Armed Forces Europe' >Armed Forces Europe<\/option><option value='Armed Forces Pacific' >Armed Forces Pacific<\/option><\/select>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_3_4_5_container' >\n                                    <label for='input_3_4_5' id='input_3_4_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP Code<\/label>\n                                    <input type='text' name='input_4.5' id='input_3_4_5' value=''    aria-required='false'   autocomplete=\"postal-code\" \/>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_4.6' id='input_3_4_6' value='United States' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><fieldset id=\"field_3_23\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_3_23\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Your connection(s) to NC State<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_3_23'><div class='gchoice gchoice_3_23_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_23.1' type='checkbox'  value='Alumna\/Alumnus'  id='choice_3_23_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_23_1' id='label_3_23_1' class='gform-field-label gform-field-label--type-inline'>Alumna\/Alumnus<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_23_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_23.2' type='checkbox'  value='Faculty\/Staff'  id='choice_3_23_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_23_2' id='label_3_23_2' class='gform-field-label gform-field-label--type-inline'>Faculty\/Staff<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_23_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_23.3' type='checkbox'  value='Parent'  id='choice_3_23_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_23_3' id='label_3_23_3' class='gform-field-label gform-field-label--type-inline'>Parent<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_23_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_23.4' type='checkbox'  value='Friend'  id='choice_3_23_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_23_4' id='label_3_23_4' class='gform-field-label gform-field-label--type-inline'>Friend<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_23_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_23.5' type='checkbox'  value='Other'  id='choice_3_23_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_23_5' id='label_3_23_5' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_3_18\" class=\"gfield gfield--type-text gfield--width-full field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_3_18\" ><label class='gfield_label gform-field-label' for='input_3_18'>How did you hear about WIN?<\/label><div class='ginput_container ginput_container_text'><input name='input_18' id='input_3_18' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_3_24\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_3_24\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >I am applying to invest as:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_3_24'><div class='gchoice gchoice_3_24_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_24.1' type='checkbox'  value='Myself as an individual'  id='choice_3_24_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_24_1' id='label_3_24_1' class='gform-field-label gform-field-label--type-inline'>Myself as an individual<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_24_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_24.2' type='checkbox'  value='Trust'  id='choice_3_24_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_24_2' id='label_3_24_2' class='gform-field-label gform-field-label--type-inline'>Trust<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_24_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_24.3' type='checkbox'  value='LLC'  id='choice_3_24_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_24_3' id='label_3_24_3' class='gform-field-label gform-field-label--type-inline'>LLC<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_24_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_24.4' type='checkbox'  value='An Entity (e.g., corporation, partnership, limited liability company, trust,etc.) in which all of the equity owners are accredited investors.'  id='choice_3_24_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_24_4' id='label_3_24_4' class='gform-field-label gform-field-label--type-inline'>An Entity (e.g., corporation, partnership, limited liability company, trust,etc.) in which all of the equity owners are accredited investors.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_24_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_24.5' type='checkbox'  value='S-Corp'  id='choice_3_24_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_24_5' id='label_3_24_5' class='gform-field-label 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such income in the current year.'  id='choice_3_25_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_25_3' id='label_3_25_3' class='gform-field-label gform-field-label--type-inline'>Individual with an annual income that was at least $200,000 in each of the two most recent years, and I expect such income in the current year.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_25_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_25.4' type='checkbox'  value='Individual with an annual income, jointly with my spouse, of at least $300,000 in each of the two most recent years, and I expect such income in the current year.'  id='choice_3_25_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_25_4' id='label_3_25_4' class='gform-field-label gform-field-label--type-inline'>Individual with an annual income, jointly with my spouse, of at least $300,000 in each of the two most recent years, and I expect such income in the current year.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_25_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_25.5' type='checkbox'  value='Other'  id='choice_3_25_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_25_5' id='label_3_25_5' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_3_26\" class=\"gfield gfield--type-text gfield--width-full field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_3_26\" ><label class='gfield_label gform-field-label' for='input_3_26'>If &quot;Other&quot;, please describe<\/label><div class='ginput_container ginput_container_text'><input name='input_26' id='input_3_26' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_3_22\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield_contains_required field_sublabel_above gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_3_22\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Terms of Use<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_consent'><input name='input_22.1' id='input_3_22_1' type='checkbox' value='1'  aria-describedby=\"gfield_consent_description_3_22\" aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_3_22_1' >I have read and agree to the terms of use<\/label><input type='hidden' name='input_22.2' value='I have read and agree to the terms of use' class='gform_hidden' \/><input type='hidden' name='input_22.3' value='2' class='gform_hidden' \/><\/div><div class='gfield_description gfield_consent_description' id='gfield_consent_description_3_22'>By submitting this application to the Wolfpack Investor Network (\"WIN\"), you acknowledge, consent and agree to the following terms and conditions:<br \/>\n<br \/>\n- Any information provided as part of your submission may be reviewed by the WIN staff and shared with WIN members and affiliates, including other angel groups, stakeholders and\/or service providers, and as required by law. WIN typically requires non-disclosure agreements from any third parties before consensually sharing information and uses other good faith efforts to protect information that is submitted, but by your submission, you hereby release WIN, its staff and members from any liability arising from or through any disclosure of such information.<br \/>\n<br \/>\n- WIN merely serves as a curator of investment opportunities for its membership, and members make individual decisions regarding any investment in applicant companies. Neither WIN\u2019s acceptance or review of your application, nor any invitation to present to the WIN membership, shall constitute a guaranty or agreement to invest in the applicant company. Your submission constitutes a representation that any information provided is and shall remain true, accurate, and complete, and you agree to maintain, update or revise any information as necessary. Any information found or determined to be false, inaccurate, incomplete or intentionally misleading will constitute grounds for immediate termination of your application.<br \/>\n<br \/>\n- WIN does not knowingly accept applications or collect data from any individual under the age of 18. 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