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" width="100%" required="required" placeholder="Email Address"/></div><div class="mpm-col-xs-12" style="display: flex; position: relative; flex-direction: column; "><input name="customField-831553" type="TELNO" style="color: #666666; width: 100%; display: block; font-size: 14px; box-sizing: border-box; margin-top: 5px; font-family: Open Sans,sans-serif; font-weight: normal; margin-left: 0; padding-top: 10px; border-color: #c2c2c2; border-style: solid; border-width: 1px; margin-right: 0; padding-left: 15px; border-radius: 3px; margin-bottom: 10px; padding-right: 15px; padding-bottom: 10px; background-color: #FFFFFF; -webkit-appearance: none; " width="100%" placeholder="Phone Number (Mobile)"/></div><div class="mpm-col-xs-12" style="display: flex; position: relative; margin-top: 10px; margin-left: 5px; padding-top: 0px; margin-right: 10px; padding-left: 0px; margin-bottom: 5px; padding-right: 0px; flex-direction: column; padding-bottom: 0px; "><div style="color: #666666; position: relative; font-size: 14px; font-family: Open Sans,sans-serif; font-weight: normal; "><h3>What interests you?</h3></div></div><div class="mpm-col-xs-12" style="display: flex; position: relative; flex-direction: column; "><table style="margin-top: 5px; margin-left: 0px; padding-top: 10px; margin-right: 0px; padding-left: 15px; margin-bottom: 5px; padding-right: 15px; padding-bottom: 10px; " cellpadding="0" cellspacing="0"><tr><td width="25" valign="top"><input name="customField-831571" type="checkbox" class="mp_checkbox" style="color: #666666; width: 15px; height: 15px; margin: 0px; display: block; box-sizing: border-box; visibility: visible; border-color: #c2c2c2; border-style: none; border-width: 1px; border-radius: 3px; background-color: #FFFFFF; " value="1"/></td><td valign="top"><div style="color: #666666; font-size: 14px; text-align: left; font-family: Open Sans,sans-serif; ">Investing in early stage New Zealand companies</div></td></tr></table></div><div class="mpm-col-xs-12" style="display: flex; position: relative; flex-direction: column; "><table style="margin-top: 5px; margin-left: 0px; padding-top: 10px; margin-right: 0px; padding-left: 15px; margin-bottom: 5px; padding-right: 15px; padding-bottom: 10px; " cellpadding="0" cellspacing="0"><tr><td width="25" valign="top"><input name="customField-831619" type="checkbox" class="mp_checkbox" style="color: #666666; width: 15px; height: 15px; margin: 0px; display: block; box-sizing: border-box; visibility: visible; border-color: #c2c2c2; border-style: solid; border-width: 1px; border-radius: 3px; background-color: #FFFFFF; " value="1"/></td><td valign="top"><div style="color: #666666; font-size: 14px; text-align: left; font-family: Open Sans,sans-serif; ">Supporting early stage kiwi companies with my expertise, and connections.</div></td></tr></table></div><div class="mpm-col-xs-12" style="display: flex; position: relative; margin-top: 10px; margin-left: 5px; padding-top: 0px; margin-right: 10px; padding-left: 0px; margin-bottom: 5px; padding-right: 0px; flex-direction: column; padding-bottom: 0px; "><div style="color: #666666; position: relative; font-size: 14px; font-family: Open Sans,sans-serif; font-weight: normal; "><h3>What communications do you want to receive?</h3></div></div><div class="mpm-col-xs-12" style="display: flex; position: relative; flex-direction: column; "><table style="margin-top: 5px; margin-left: 0px; padding-top: 10px; margin-right: 0px; padding-left: 15px; margin-bottom: 5px; padding-right: 15px; padding-bottom: 10px; " cellpadding="0" cellspacing="0"><tr><td width="25" valign="top"><input name="customField-886537" type="checkbox" class="mp_checkbox" style="color: #666666; width: 15px; height: 15px; margin: 0px; display: block; box-sizing: border-box; visibility: visible; border-color: #c2c2c2; border-style: solid; border-width: 1px; border-radius: 3px; background-color: #FFFFFF; " value="1"/></td><td valign="top"><div style="color: #666666; font-size: 14px; text-align: left; font-family: Open Sans,sans-serif; ">Introduction to Angel Investing</div></td></tr></table></div><div class="mpm-col-xs-12" style="display: flex; position: relative; flex-direction: column; "><table style="margin-top: 5px; margin-left: 0px; padding-top: 10px; margin-right: 0px; padding-left: 15px; margin-bottom: 5px; padding-right: 15px; padding-bottom: 10px; " cellpadding="0" cellspacing="0"><tr><td width="25" valign="top"><input name="customField-831580" type="checkbox" class="mp_checkbox" style="color: #666666; width: 15px; height: 15px; margin: 0px; display: block; box-sizing: border-box; visibility: visible; border-color: #c2c2c2; border-style: solid; border-width: 1px; border-radius: 3px; background-color: #FFFFFF; " value="1"/></td><td valign="top"><div style="color: #666666; font-size: 14px; text-align: left; font-family: Open Sans,sans-serif; ">Newsletter</div></td></tr></table></div><div class="mpm-col-xs-12" style="display: flex; position: relative; flex-direction: column; "><table style="margin-top: 5px; margin-left: 0px; padding-top: 10px; margin-right: 0px; padding-left: 15px; margin-bottom: 5px; padding-right: 15px; padding-bottom: 10px; " cellpadding="0" cellspacing="0"><tr><td width="25" valign="top"><input name="customField-831598" type="checkbox" class="mp_checkbox" style="color: #666666; width: 15px; height: 15px; margin: 0px; display: block; box-sizing: border-box; visibility: visible; border-color: #c2c2c2; border-style: solid; border-width: 1px; border-radius: 3px; background-color: #FFFFFF; " value="1"/></td><td valign="top"><div style="color: #666666; font-size: 14px; text-align: left; font-family: Open Sans,sans-serif; ">Event Invites</div></td></tr></table></div><div class="mpm-col-xs-12" style="display: flex; position: relative; flex-direction: column; "><table style="margin-top: 5px; margin-left: 0px; padding-top: 10px; margin-right: 0px; padding-left: 15px; margin-bottom: 5px; padding-right: 15px; padding-bottom: 10px; " cellpadding="0" cellspacing="0"><tr><td width="25" valign="top"><input name="customField-831613" type="checkbox" class="mp_checkbox" style="color: #666666; width: 15px; height: 15px; margin: 0px; display: block; box-sizing: border-box; visibility: visible; border-color: #c2c2c2; border-style: solid; border-width: 1px; border-radius: 3px; background-color: #FFFFFF; " value="1"/></td><td valign="top"><div style="color: #666666; font-size: 14px; text-align: left; font-family: Open Sans,sans-serif; ">Deal Opportunities</div></td></tr></table></div><div class="mpm-col-xs-12" style="display: flex; position: relative; margin-top: 10px; margin-left: 5px; padding-top: 0px; margin-right: 10px; padding-left: 0px; margin-bottom: 5px; padding-right: 0px; flex-direction: column; padding-bottom: 0px; "><div style="color: #666666; position: relative; font-size: 14px; font-family: Open Sans,sans-serif; font-weight: normal; "><h3>Where did you hear about Enterprise Angels?</h3></div></div><div class="mpm-col-xs-12" style="display: flex; position: relative; flex-direction: column; "><select name="customField-881399" style="color: #666666; width: 100%; display: block; font-size: 14px; box-sizing: border-box; margin-top: 5px; font-family: Open Sans,sans-serif; margin-left: 0px; padding-top: 10px; border-color: #c2c2c2; border-style: solid; border-width: 1px; margin-right: 0px; padding-left: 15px; border-radius: 3px; margin-bottom: 5px; padding-right: 15px; padding-bottom: 10px; background-color: #FFFFFF; -webkit-appearance: none; "><option style="color: #666666; " value="" disabled="disabled" selected="selected">Choose an option</option><option value="Colleague">Colleague</option><option value="Deal">Deal</option><option value="Event">Event</option><option value="Internet Search">Internet Search</option><option value="Member">Member</option><option value="Partner">Partner</option><option value="Social Media">Social Media</option><option value="Website">Website</option><option value="Word of Mouth">Word of Mouth</option><option value="Other Angel Group">Other Angel Group</option><option value="Other">Other</option></select></div><div class="mpm-col-xs-12" style="display: flex; position: relative; margin-top: 10px; margin-left: 5px; padding-top: 0px; margin-right: 10px; padding-left: 0px; margin-bottom: 5px; padding-right: 0px; flex-direction: column; padding-bottom: 0px; "><div style="color: #666666; position: relative; font-size: 14px; font-family: Open Sans,sans-serif; font-weight: normal; "><h3>Can you confirm you can certify as a Wholesale Investor?</h3><div><p>To invest, you must qualify as a Wholesale Investor under the Financial Markets Conduct Act 2013 and certify your understanding of early‑stage investment risks. Eligible Wholesale Investors also require verification from a New Zealand accountant, financial adviser, or lawyer.</p><p>Not sure if you qualify? Take our quick <a href="https://www.enterpriseangels.co.nz/wholesale-investor-eligibility/" target="_blank" rel="noopener" data-mce-href="https://www.enterpriseangels.co.nz/wholesale-investor-eligibility/" style="color: #57863c;">Wholesale Investor Quiz</a>.</p></div></div></div><div class="mpm-col-xs-12" style="display: flex; position: relative; flex-direction: column; "><select name="customField-950895" style="color: #666666; width: 100%; display: block; font-size: 14px; box-sizing: border-box; margin-top: 5px; font-family: Open Sans,sans-serif; margin-left: 0px; padding-top: 10px; border-color: #c2c2c2; border-style: solid; border-width: 1px; margin-right: 0px; padding-left: 15px; border-radius: 3px; margin-bottom: 5px; padding-right: 15px; padding-bottom: 10px; background-color: #FFFFFF; -webkit-appearance: none; "><option style="color: #666666; " value="" disabled="disabled" selected="selected">Choose an option</option><option value="No">No</option><option value="Yes">Yes</option><option value="Yes but I have nobody in NZ to confirm such status">Yes but I have nobody in NZ to confirm such status</option><option value="I am not sure">I am not sure</option></select></div><div class="mpm-col-xs-12" style="display: flex; position: relative; margin-top: 10px; margin-left: 5px; padding-top: 0px; margin-right: 10px; padding-left: 0px; margin-bottom: 5px; padding-right: 0px; flex-direction: column; padding-bottom: 0px; "><div style="color: #666666; position: relative; font-size: 14px; font-family: Open Sans,sans-serif; font-weight: normal; "><h3>Confidentiality of Information</h3></div></div><div class="mpm-col-xs-12" style="display: flex; position: relative; flex-direction: column; "><table style="margin-top: 5px; margin-left: 0px; padding-top: 10px; margin-right: 0px; padding-left: 15px; margin-bottom: 5px; padding-right: 15px; padding-bottom: 10px; " cellpadding="0" cellspacing="0"><tr><td width="25" valign="top"><input name="customField-950896" type="checkbox" class="mp_checkbox" style="color: #666666; width: 15px; height: 15px; margin: 0px; display: block; box-sizing: border-box; visibility: visible; border-color: #c2c2c2; border-style: solid; border-width: 1px; border-radius: 3px; background-color: #FFFFFF; " value="1" required="required"/></td><td valign="top"><div style="color: #666666; font-size: 14px; text-align: left; font-family: Open Sans,sans-serif; ">I agree that all information provided by Enterprise Angels is confidential and will not be disclosed outside the Enterprise Angels membership without prior written consent. I also agree to declare any conflicts of interest and comply with all relevant legislation.</div></td></tr></table></div><div class="mpm-col-xs-12" style="display: flex; position: relative; margin-top: 5px; margin-left: 5px; padding-top: 0px; margin-right: 10px; padding-left: 0px; margin-bottom: 5px; padding-right: 0px; flex-direction: column; padding-bottom: 0px; "><div style="color: #666666; position: relative; font-size: 14px; font-family: Open Sans,sans-serif; font-weight: normal; ">Further information can be found as follows: <br><ul><li><a href="http://enterpriseangels.co.nz/legal" target="_blank" rel="noopener" style="color: #57863c;">Full Confidentiality and Conflict of Interest Policies</a></li><li><a href="https://www.enterpriseangels.co.nz/compliance/" target="_blank" rel="noopener" style="color: #57863c;">Enterprise Angels&rsquo; compliance requirements</a></li></ul></div></div><div class="mpm-col-xs-12" style="display: flex; position: relative; margin-top: 5px; margin-left: 0px; margin-right: 0px; margin-bottom: 5px; flex-direction: column; "><div style="align-self: center">                        <div class="g-recaptcha" id=mpmRecaptchampFrm777f61319c684228b2ff16ba230b19dd data-theme="light" data-size="normal"></div>                     </div></div><div class="mpm-col-xs-12" style="display: flex; position: relative; align-items: center; flex-direction: column; "><button class="" style="color: #FFFFFF; width: 50%; cursor: pointer; display: block; font-size: 16px; box-sizing: border-box; margin-top: 10px; text-align: center; word-break: break-word; font-family: Open Sans,sans-serif; font-weight: normal; margin-left: 10px; padding-top: 10px; border-color: #543881; border-style: none; border-width: 1px; margin-right: 10px; padding-left: 10px; border-radius: 3px; margin-bottom: 10px; padding-right: 10px; padding-bottom: 10px; background-color: #8ab740; " width="100%">SUBSCRIBE</button></div><div id="mpmessageholder" class="mpm-col-xs-12" style="display: flex; position: relative; margin-top: 0px; margin-left: 0px; margin-right: 0px; margin-bottom: 5px; flex-direction: column; "><div id="mpmessage" class="mpmessageholder" style="color: #000000; position: relative; font-size: 14px; text-align: center; font-family: Open Sans,sans-serif; padding-top: 0px; padding-left: 0px; padding-right: 0px; padding-bottom: 0px; "></div></div></div></div></div></form>';
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