[General information/Legal]

General Interest, Qualification & Accredited Investor Form

Lilliothea Investment Management, LLC

Please submit your information using the form below.

* denotes required field

First Name*
Last Name*
Occupation
Title
Organization/Company
Address*
Address2
City*
State/Province*
Zip/Postal Code*
Country
Phone Number*
Fax
Email Address*
Email Address Verify*
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What professional description would best suit you?
Investor Type
.
If you’re an investor, please complete following fields

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Percentage allocated to alternative investments:
Allocation Percentage
.
Which of the following investments do you currently own?
Investments Owned
.
Years of investment experience:
Select number of years
.

How did you find out about Lilliothea Investment Management, LLC and/or the Lilliothea Opportunistic Long/Short Fund, LP?

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