Access to www.quantumadv.com is restricted. In order to obtain access, please complete and submit this form. You may be contacted by a member of our Investor Relations team to verify the information you submit. Upon approval the username and password will be activated for you. The investment funds described in this website have not been registered under the federal securities laws of the United States, the securities laws of any state, or the laws of any other jurisdiction. This website shall not constitute an offer to sell or the solicitation of an offer to purchase shares of any of such funds in any jurisdiction. Such an offer may only be made by the private placement memorandum for the relevant fund, and only to investors who meet certain eligibility requirements. This registration form is not an application form to subscribe for interests in or shares of any of the funds.

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Background Information
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I currently have or have previously made investments in (please check all that apply):
Stocks or bonds
Mutual funds
Futures, commodities, options or other derivative instruments
Real estate
Private investment funds (hedge funds, private equity funds, commodity pools, etc.)
Other
None of the above

QUALIFICATION

Accredited Investor Status

The Investor hereby represents and warrants that it is an "Accredited Investor" within the meaning of Rule 501(a) under the Securities Act and has initialed the box or boxes below which are next to the categories under which the Investor qualifies as an Accredited Investor. As one of the qualifications of being an Accredited Investor, the Investor agrees it has the financial ability to bear the economic risk of the Investor's investment and has adequate means for providing for the Investor's current needs and possible personal and other contingencies. The Investor is:

For Individual Investors Only
A.   The Investor is a natural person whose net worth (exclusive of the value of his primary residence), either individually or jointly with such person's spouse, exceeds $1,000,000.

B.   The Investor is a natural person who had individual income in excess of $200,000, or joint income with that person's spouse in excess of $300,000, in each of the previous two calendar years and reasonably expects to reach the same income level in the current calendar year.

For Trusts, Partnership, Companies and Other Entities; Financial Institutions
C.   The Investor is a corporation, partnership, Massachusetts or other business trust or other organization described in Section 501(c)(3) of the Internal Revenue Code, or Massachusetts or similar business trust, not formed for the specific purpose of acquiring an Interest, with total assets in excess of $5,000,000.

D.   The Investor is an entity which falls within one of the following categories of accredited investors set forth in Rule 501(a) of Regulation D under the Securities Act ("Regulation D"):

  (i) A bank as defined in Section 3(a)(2) of the Securities Act, or any savings and loan association or other institution as defined in Section 3(a)(5)(A) of the Securities Act whether acting in its individual or a fiduciary capacity.

(ii) A broker or dealer registered pursuant to Section 15 of the Securities Exchange Act of 1934.

(iii) An insurance company as defined in Section 2(13) of the Securities Act.

(iv) An investment company registered under the Investment Company Act of 1940 or as a business development company as defined in Section 2(a)(48) of that Act.

(v) A Small Business Investment Company licensed by the U.S. Small Business Administration under Section 301(c) or (d) of the Small Business Investment Act of 1958.

(vi) Any plan established and maintained by a state, its political subdivisions, or any agency or instrumentality of a state or its political subdivisions, for the benefit of its employees, if such a plan has total assets in excess of $5,000,000.

(vii) Any private business development company as defined in Section 202(a)(22) of the Investment Advisors Act of 1940.

(viii) An employee benefit plan within the meaning of Title I of the Employee Retirement Income Security Act of 1974, if the investment decision is made by a plan fiduciary, as defined in Section 3(21) of such Act, which is either a bank, savings and loan association, insurance company or registered investment adviser or if the employee benefit plan has total assets in excess of $5,000,000 or, if a self-directed plan, with investment decisions made solely by persons that are accredited investors.

(ix) A trust, with total assets in excess of $5,000,000 not formed for the specific purpose of acquiring any offered securities, whose purpose is directed by a sophisticated person as described in Rule 506(b)(2)(ii) of Regulation D.

Others
E.   The Investor is an entity in which all of the equity owners are accredited investors and described in one or more of the categories above.

Please choose the category that best describes you:
Individual
Family office
Registered Investment Adviser
Foundation
Fund-of-Funds
Institution
Consultant
Other:


Thank you very much for your time. By pressing the "Submit/I Agree" button below, you agree that you have filled in this questionnaire completely, truthfully and to the best of your ability and that you also have read and agree to the Terms of Use Agreement which you should review carefully.

Founded in 1999, Quantum Capital Management LLC is a private value oriented investment company.