Invest Name of Company*This is a:*New Investor RegistrationInvestor RenewalInvestment Amount*Bronze Division: $400 - $999 per yearSilver Division: $1,000 - $4,999 per yearGold Division: $5,000 - $9,999 per yearDiamond Division: $10,000 - $24,999 per yearPlatium Division: $25,000 – $49,999 per yearFounders Division: $50,000 per year & abovePrimary Contact PersonSalutationMr.Mrs.Ms.Dr.Name* First Last Title*NicknameEmail Address* Secondary Contact PersonSalutationMr.Mrs.Ms.Dr.Name First Last TitleNicknameEmail Address Other InformationAddress* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone Number*ExtensionFax NumberCell NumberWeb Site Address About Your BusinessYear EstablishedNAICS (SIC) CodeSearch for your NAICS code at http://www.census.gov/epcd/www/naics.htmlNAICS (SIC) DescriptionBusiness CategoryAccountingAccommodationsAttractionsAutomobile DealershipsBusiness Services - Communications ServivesBusiness Services - Computer ServicesBusiness Services - Event ServicesBusiness Services - Environmental ServicesBusiness Services - LandscapingBusiness Services - Marketing/AdvertisingBusiness Services - Office EquipmentBusiness Services - Office FurnitureBusiness Services - Office SuppliesBusiness Services - PhotographersBusiness Services - Printing/GraphicsBusiness Services - Waste Removal ServicesBuilders/ContractorsBuilding Equipment/MaterialsDevelopersEducational InstitutionsEngineers/ArchitectsFinancial InstitutionsFinancial ServicesFuel SupplyHealth CareHospitalityIndustrial SupplyInsuranceLegal ServicesLogistics - TransportationLogistics - Warehouse/DistributionManufacturingNon-profit/Not-for-profitPublishingReal Estate Services - Agency/BrokersReal Estate Services - Abstract & TitleRetail - CleanersRetail - FloristsTradesUtilitiesOtherTotal # of EmployeesTotal # of Employees in Saratoga CountyBusiness Description:Please describe your business in 25 words or lessPayment InformationContact Name (If different from name on card) First Last CompanyBilling Address (Use address bill is mailed to) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country PhoneFaxPayment Type*CheckCredit CardAmount to Charge*Amount to Charge* Credit Card* American ExpressMasterCardVisa Card Number Month010203040506070809101112 Year20212022202320242025202620272028202920302031203220332034203520362037203820392040 Expiration Date Security Code Cardholder Name CAPTCHA
