how to join IFA

Interested in becoming a Registered Representative with ING Financial Advisers? Please complete and submit the forms below.

First Name *

Last Name *

Organization Name

Email Address *

Address *

Building/Suite

City *

State

Zip

Work Phone *

Cell Phone

- -

Home Phone *

Web Site

- -

Who is your current Broker/Dealer?

How long have you been registered with your current Broker/Dealer? *

Not with a broker/dealer
0-3 years
4-9 years
10+ years

What securities licenses do you currently hold? (check all that apply) *

Do you sell in the Defined Contribution business?

Yes No

Where do you seek to grow your business "new clients"?

How much did you produce last year in securities? GDC? *

What is your current retail product mix? (check all that apply) *

Do you engage in RIA Activity? *

Yes No Fee For Plans Assets Under Mgmt

What kind of representative are you? *

	Affiliated Representative
	Independent Representative
	Associated with a Bank

Additional Comments

N/A
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