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Needs/Eligibility
Intake Form

Film/TV, etc.
--- Funding Eligibility Analysis ---
--- By ir@globalcrossroadscapital.com ---

Standard questions to be expected from most formats of asset-based
film financiers, as well as, equity venture capital institutional investors

  Individual shareholder participation requests are addressed by 

"Public/Private Offerings" Affiliate

Full Name
Your Email Address
Please confirm your email address:
Amount Desired (from $100,000 )
Specify Pre/Post-Production Amounts:
Production Company Name:
Title:
Owner of Underlying rights :
Contracts being submitted by mail? :
Genre:
Budget:
Individual Producers :
Principal Cast :
Director :
Finance Model :
Production Financier (Bank):
Bank letter of commitment sent via :
Loan Officer :
Phone :
( ) Ext#
Equity Investors :
Subsidies / other available financing :
Status of Production Financing :
Completion Guarantor :
Phone :
( ) Ext#
Sales Agent :
Phone :
( ) Ext#
Sales Estimates (provide documentation) :
Presales :
Attorney :
Phone :
( ) Ext#
Contact Information
Name :
Phone :
( ) Ext#
Address :
City, State, Country :
* How did you hear of us? & Funding Request Summary:
Submission of this brief needs assessment form is both unrelated to and
does not deem completion of each capital providers application process.




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Global Crossroads Capital 2007-2008