Cottingham Management Company, LLC -- MANAGEMENT

Your Name:
Your Email:
Address:

City, State, Zip:
Day Phone:


Please initial each item below that applies:
	1.	Subscriber is an individual who has a net worth, including assets held jointly with Subscriber's spouse, if appropriate, of not less than $1,000,000.
	2.	Subscriber had individual income (exclusive of any income attributable to his or her spouse) of more than $200,000 in each of the past two years, or joint income with his or her spouse of more than $300,000 in each of those years, and reasonably expects to reach the same income level in the current year.
	3.	Subscriber is a bank as defined in Section 3(a)(2) of the Securities Act of 1933.
	4.	Subscriber is a savings and loan association as defined in Section 3(a)(5)(A) of the Securities Act of 1933.
	5.	Subscriber is an insurance company as defined in Section 2(13) of the Securities Act of 1933.
	6.	Subscriber is an investment company registered under the Investment Company Act of 1940.
	7.	Subscriber is a business development company as defined in Section 2(a)(48) of the Investment Company Act of 1940.
	8.	Subscriber is 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.
	9.	Subscriber is an employee benefit plan within the meaning of Title 1 of the Employee Retirement Income Security Act of 1974, and one of the following applies [check one]: (a) the investment decision is being made by a plan fiduciary, as defined in Section 3(21) of such Act, which is either a bank, insurance company, or registered investment advisor, or (b) Subscriber has total assets in excess of $5,000,000, or (c) if a self-directed plan, Subscriber's investment decisions are made solely by accredited investors.
	10.	Subscriber is a private business development company as defined in Section 202(a)(22) of the Investment Advisers Act of 1940 or a broker-dealer registered pursuant to Section 15 of the Securities Exchange Act of 1934.
	11.	Subscriber is a 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.
	12.	Subscriber (a) has total assets in excess of $5,000,000, and (b) was not formed for the specific purpose of acquiring a Fund Interest, and (c) is one of [check one]: an organization described in Section 501(c)(3) of the Internal Revenue Code (tax exempt organization), or a corporation, or a Massachusetts or similar business trust, or a partnership or limited liability company. Subscriber (a) is a trust with total assets in excess of $5,000,000, and (b) was not formed for the specific purpose of acquiring a Fund Interest, and (c) Subscriber's purchases are directed by a person who has such knowledge and experience in financial and business matters that he/she is capable of evaluating the merits and risks of investment in the Fund.

Upon acceptance of submission we will email you with your access login and password: