Online Application Form

I confirm that I am 18 years of age or older, and personally possess sufficient knowledge and experience in financial and business matters (including experience with investments of a similar nature to an investment in the Company for the Securities) to be capable of evaluating the merits and risks of an investment in the Company. I acknowledge that the Company is not providing advice on this investment and confirm that I have taken such independent advice (including from a Financial Intermediary) that I deem necessary or desirable.

I confirm that I have read and understood the Information Memorandum (and in particular the section headed “Risk Factors” and the terms and conditions of application for the Instrument set out therein). I confirm that, in making my application, I am relying solely on the information contained in the Investor Documentation and my own enquiries, and not on any information or representation in relation to the proposal.

I agree and undertake, if my application is accepted, to observe, perform and be bound by the terms and conditions set out in the Investor Documentation.

I confirm that I wish to invest on the basis of an assessment that I have sufficient experience and knowledge to make my own investment decisions and that I understand the risks involved in relation to the Company.

I am aware that investor compensation may not be open to me if that I lose money I invest in the Company.

I confirm that I have read and understood the sections headed “Important Notice” and “Risk Factors” in the Information Memorandum and that I understand the risks involved in making an investment in the Company.

I acknowledge that this Application Form is not transferable or assignable.

I confirm my agreement that this Application Form be governed by and construed in accordance with the laws of England and Wales and that the courts of England and Wales shall have exclusive jurisdiction to hear and determine any suit, action or proceedings and to settle any disputes which may arise out of or in connection with this Application Form and, for such purposes, I irrevocably submit to the jurisdiction of such courts. In addition, I irrevocably waive any objection which I might now or hereafter have to the courts of England and Wales being nominated as the forum to hear and determine any such suit, action or proceedings and to settle any such disputes, and agree not to claim that any such court is not a convenient or appropriate forum.

I agree that the foregoing representations, warranties, agreements and acknowledgments shall survive the date of my investment in the Company and this Application Form shall be binding upon and inure to the benefit of all parties and their successors and permitted assignees.

I agree that any term or provision of this Application Form which is invalid or unenforceable in any jurisdiction shall, as to such jurisdiction, be ineffective to the extent of such invalidity or unenforceability without rendering invalid or unenforceable the remaining terms or provisions of this Application Form or affecting the validity or enforceability of any of the terms or provisions of this Application Form in any other jurisdiction.

I undertake to notify the Company immediately if there are ever any relevant circumstances of which the Company should be aware in relation to my classification as a high net worth, sophisticated investor or restricted investor or the appropriateness or suitability of the investment for me.

I confirm that if the application is made on behalf of a company or trust, that I have the authority to enter into contracts for such a legal entity.

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