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Instructions

Thank you for your interest in Sea Island Divers. To go along with your investment we will need to get some information about you, like who you are and where to send your money! Please print this page and fill out the information below, then send it with your investment to:

Jason J. Owen
212 Burroughs Ave.
Beaufort, SC 29902


The Form


Last Name:________________________ First Name:________________________ Middle Initial:______

Address:____________________________________________________________________________________

Phone Number:(______)______-______________ Investment Amount:$_________________________

Please tell us how you heard about our site:________________________________________________

____________________________________________________________________________________________

Please circle one of the following that best describes you:


scuba diver     snorkeler     swimmer     wader    beach comber     water drinker

Please read:

I understand that the capitol I am sending is an investment. It will be held in an interest bearing account until full funding has been raised for Sea Island Divers. I understand that if funding is not completed in 12 months from the date my investment is received that I may have my monies returned to me in full with any interest it has earned. Sea Island Divers may buy out my partnership at any time at a rate of 125% of my original investment. I will receive quarterly statements and earnings on my investment once funding is completed.

Signed:____________________________________________________Dated:_____/_____/_____






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