Thank you for your interest in Founders Financial. At Founders, what sets us apart from the rest of the industry is exactly what makes us so strong - it's our commitment to our Members, to their success, and to our shared values. If you are ready to experience the difference and schedule your Discover Founders Call with our President please complete the information request form below.

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Contact Information
* Full Name:
* Business Name:
* Title:
* Business Address:
(* Street)
 
(* City) (* State) (* Zip)
* Business Phone: * Business Fax:
Private/Personal Email Address: Web Address:
Tax ID or Social Security No.:
* Area(s) of Specialization:
* How many years have you been in business?
* Current B/D:
Current Insurance Resources:
* What licenses do you hold?
CLU ChFC CFP CEP CSA
Series 6 Series 7 Series 24/26 Series 63 Series 65/66
Other:
* Do you have any curent/past regulatory issues or FINRA disclosure events?
Yes No
If yes, please explain:
Production and Target Market Data
* What is your average annual production?
* Comprised of:
GDC: $ Insurance: $
Fee: $ Other: $
What is your current payout rate?
From where are your current revenues derived?
% of activity
% Asset Management Fees % Investment Commissions
% Financial Planning Fees % Life Insurance
% Qualified Plans % Long Term Care
% Disability Income % Other:
What are your target markets?
% Family Markets % Executive Companies
% Small Business % High Net Worth
% Senior Markets % Other:
What is your approximate product mix break down?
% Wrap Account Managment Fees % Stocks
% Separate Account Management Fees % Municipal Bonds
% Financial Planning % Taxable Bonds
% Mutual Funds % UITs
% Variable Annuities % Options
% Fixed Annuities % Limited Partnerships
% Variable Insurance % Covered Calls
% Fixed Insurance % Other:
Personal Value Proposition
What is important to you?
While Founders Financial, Inc. is comprised of like-minded financial professionals, each is unique. Please share with us what specifically motivates you and what you seek professionally from a relationship with Founders Financial.
Historical Background of Your Organization
(Please provide a short overview of you and your organization)
Additional Information
What questions do you have about Founders Financial?
How did you hear about Founders Financial?
Magazine Advertisement (Which magazine?)
From a current Member (Please provide name)
An Internet Search Engine (Which search engine?)
Correspondence from Founders Financial
Direct Mail from Founders Financial
E-Mail from Founders Financial
Other:
To establish your initial discovery meeting, please provide us with three convenient appointment options. We will be emailing you a meeting confirmation shortly after receiving and reviewing your request.
* Specific Date: * Time of Day:
Specific Date: Time of Day:
Specific Date: Time of Day: