Atmicroinvestments Entry Form
Section 1: Personal Information
Full Name: ______________________________
Email Address: ___________________________
Mobile Number: ___________________________
ID/Passport Number: ______________________
Location (City/Town): _____________________
Section 2: User Type
Please select one:
☐ I am an Entrepreneur seeking funding
☐ I am an Investor interested in supporting businesses
Section 3A: For Entrepreneurs
(Complete only if you selected “Entrepreneur”)
Business Name: ___________________________
Business Type: ___________________________
Brief Description of Product/Service:
Funding Goal (ZAR): _____________________
Share Price (e.g., R1): ___________________
Company Registration Number :___________
Bank Account Details (for payouts): ________
Upload Pitch Materials (images/video link):
☐ I agree to provide regular updates to investors
☐ I confirm that all information provided is accurate
Section 3B: For Investors
(Complete only if you selected “Investor”)
Initial Investment Amount (ZAR): ___________
Preferred Business Types (optional):
☐ Food & Beverage
☐ Beauty & Wellness
☐ Tech & Innovation
☐ Agriculture
☐ Other: _______________
☐ I understand the risks of micro-investing
☐ I agree to the platform’s terms and conditions
Section 4: Consent & Submission
☐ I consent to Atmicroinvestments.help storing and processing my data for platform use
☐ I agree to receive updates and notifications related to my account
Signature: _______________
Date: ___________________
N.B email form and proof of payment to AT.Microinvestment@outlook.com.Both investor and entrepreneurs must deposit R1.
Account number:2437730768
Capitec:
Reference:(business name)-investor/Entrepreneurs.
Both investor and entrepreneurs must deposit R1
AT.Micro Investments 