*Name:

Age:

*Address:

*City:

*State:

ZIP:

*Country:

*US Citizen:

Select One Yes No

*Work Telephone:

Work Fax:

Home Telephone:

Home Fax:

*E-mail:

Professional Occupation:
Tax ID or Social Security Number:
Dependents:	Number:          Ages:  Relationship:

*Total Net Worth:

Select One Less than $1,000,000 $1,000,000 - $2,000,000 $2,000,001 - $3,000,000 $3,000,001 - $4,000,000 $4,000,001 - $5,000,000 $5,000,001 - $10,000,000 Greater than $10,000,001

*Liquid Net Worth:

Select One Less than $1,000,000 $1,000,000 - $2,000,000 $2,000,001 - $3,000,000 $3,000,001 - $4,000,000 $4,000,001 - $5,000,000 $5,000,001 - $10,000,000 Greater than $10,000,001

Annual Earnings:

2002:   Less than $200,000    $200,000 or Greater
2003:   Less than $200,000    $200,000 or Greater
Estimated 2007:   Less than $200,000    $200,000 or Greater
 

*Are you filling this out on behalf of your employer/company?  Select One Yes No

Investment Objectives:

  Inflation Hedge
  Recession Hedge
  Income
  Speculative Profit
  Long Term Capital Gains
Other: 

Portfolio Analysis:  Hedge Fund    $     %  Stocks    $     %  Bonds    $     %  Mutual Funds    $     %  IRA/Keogh    $     %  Cash/CD's    $     %  Bank Savings    $     %  Real Estate    $     %  Insurance    $     %  Gold/Silver    $     %  Commodities    $     %  Other    $     %

*Do you own securities and/or other liquid investments having an aggregate market value of at least $2,000,000? (Qualified Eligible Participant) Select One Yes No

Prior investments (include stocks,  bonds, limited partnerships, new ventures, etc.):
Name of Issuer	Type of Investment	Year of Investment	Amount Invested

Please identify specific hedge fund  or managed account investments:   Preferred size of investment: Minimum $ Maximum $ *Do you believe that you have sufficient knowledge and experience in financial and business matters to evaluate the merits and risks of hedge funds and managed  accounts? Select One Yes No Please list any academic or business experiences that relate to your ability to evaluate the  merits and risks of hedge funds and managed accounts.   HEDGE FUNDS AND MANAGED ACCOUNT  INVESTMENTS INVOLVE A HIGH DEGREE OF RISK AND ARE SUITABLE ONLY FOR PERSONS OF SUBSTANTIAL FINANCIAL MEANS WHO HAVE NO NEED FOR LIQUIDITY OF THEIR INVESTMENTS AND WHO COULD  BEAR THE ENTIRE LOSS OF THEIR INVESTMENT. *The current value of my liquid assets (cash, freely marketable securities, cash surrender value of life insurance, etc.) is sufficient to provide for my current and anticipated  needs and possible contingencies, so that I am capable of bearing the economic risk of hedge fund and managed account  investments. Select One Yes No *I hereby acknowledge that the information I will be able to access on Winchester's web site is not an Offer, but is for information purposes only.  I will not share my password.  Any further formal relationship with Winchester may require additional steps to insure adherence to local rules and regulations Select One Yes No *I hereby represent, warrant and covenant that: (i) I am not, nor is any person or entity controlling, controlled by or under common control with me, a person or entity that acts, directly or indirectly, (a) in contravention of any U.S. or international laws and regulations, including anti-money laundering regulations or conventions, (b) on behalf of terrorists or terrorist organizations, including those persons or entities that are included on the List of Specially Designated Nationals and Blocked Persons maintained by the U.S. Treasury Department's Office of Foreign Assets Control (the list may be accessed on the web at http://www.treas.gov/offices/enforcement/ofac/), as such list may be amended from time to time, (c) for a senior foreign political figure, any member of a senior foreign political figure's immediate family or any close associate of a  senior foreign political figure, unless Winchester, after being specifically notified  by you that you are such a person, determines that access shall be permitted, or (d) for a foreign shell bank, and (ii) to the extent that I have any beneficial  owners, (a) I have carried out thorough due diligence to establish the identities of such beneficial owners, and (b) based on such due diligence, I reasonably believe that no such beneficial owners are persons described in (i) above. Select One Yes No *By electronically signing below,  I am affirming that all the information contained herein  is true and correct to the best of my knowledge and belief.  I hereby authorize Winchester representatives to contact me at the telephone number listed above. Signature (please type your name):  Winchester Fund of Funds, LLC suggests that you print this form for your records  before clicking the "Submit" button below.