1.) Are you currently seeking to raise capital for your business?
Yes If yes, how much?
No
 
2.) Are you an operating company generating revenue from the sale of goods or services?
Yes If yes, what is your current revenue?
No If no, do you have a reasonable business plan to develop an active business and the financial resources to carry out the plan? Yes No
 
3.) What industry is your company operating in?
 
4.) Would your company benefit from the exposure that it and its products and services would receive from becoming a Public Company?
Yes
No
 
5.) Are you a reporting issuer in Canada?
Yes
No
 
6.) Does your company have a history as a listed company?
Yes If yes, do you have a working capital of over $50,000? Yes No
No If no, do you have a working capital of over $100,000? Yes No
 
7.) Is a minimum of 500,000 shares publicly held?
Yes If yes, how many?
No
 
8.) Are the shares that are publicly held freely tradeable?
Yes If yes, how many?
No
 
9.) What is the value of the publicly held freely tradeable shares?
 
10.) Do you have over 150 public shareholders holding at least 100 shares each?
Yes If yes, how many?
No
Thank you for completing our questionnaire. You have taken the first step toward taking your company public! Please provide your contact information to receive the results of the questionnaire via email.
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