IGNITE IMPACT FUND INTAKE FORM

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Hybridigm Consulting, Inc. is the Philippine arm of Ignite Impact Fund, LLC and Ignite Innovations Capital Partners, LLC
(collectively, "Ignite"). Ignite regard your privacy with utmost importance. As such, we ensure that all personal data collected
are protected at all times in accordance with Republic Act No. 10173, otherwise known as the Data Privacy Act of 2012
(“Data Privacy Act” or the “Act”), its corresponding Implementing Rules and Regulations (“IRR”), and the existing
Memorandum Circulars, Advisories, and other issuances issued by the National Privacy Commission (“NPC”). Our privacy
policy may be found at https://tinyurl.com/HCIDataPrivacyPolicy. By ticking the box below, you agree that you have read
this form, understood its contents and consent to the processing of your personal data. Your consent does not preclude
the existence of other criteria for lawful processing of personal data, and does not waive any of your rights under the Data
Privacy Law of 2012.

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