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Impact Backer Interest Form

Put your commitment to impact into practice.
Already investing for impact, exploring your first steps, or bringing expertise and connections?

Tell us about your interests and how you might contribute to Black Capital Exchange, the proposed two-sided readiness pilot by MELLA Supply × Strategic Disruption Consulting.

Around 3 minutes.

1. Your details

Full name

Email address

Where are you based?

Organisation and role

LinkedIn or professional website

2. Your starting point

Which best describes you?

A
B
C
D
E

What interests you about backing diverse businesses?

3. Your potential contribution

What would you like to explore contributing?

Which sectors or business areas do you know best?

What experience, resources or relationships could be relevant?

4. Your participation

What would you value most from participating?

What time could you realistically make available?

A
B
C
D

5. Contact and permissions

Would you like us to contact you about a possible role?

A
B

Anything that would help you participate comfortably?

Send me occasional MELLA programme and event updates.

We will use your responses to review your interest and, where requested, discuss possible participation.
Important information
Financial participation is optional. Investments involve risk, including possible loss. This form is not an investment offer, suitability assessment or request to transfer money. Programme participation does not confer investment qualifications or authorisation.