application.usfati.org Open in urlscan Pro
34.68.234.4  Public Scan

Submitted URL: https://fbehehe.r.af.d.sendibt2.com/tr/cl/3JXchiTS4oa-ljpjJHGDf0TK6nuS3hKd7MZq2J9QJ0k4t-8WRIQfizQqzGZOapns5dPfnnS-a4fFQ3sOEVefFRVFuv...
Effective URL: https://application.usfati.org/
Submission: On July 06 via manual from US — Scanned from FR

Form analysis 1 forms found in the DOM

Name: builder-form

<form id="_builder-form"
  style="background-color:#FFFFFF;color:#undefined;border:5px solid #E58921FF;border-radius:4px;max-width:548px;width:100%;margin-top:;border-color:#E58921FF;padding-top:0px;padding-bottom:0px;padding-left:20px;padding-right:20px;box-shadow:0px 0px 0px 0px #FFFFFF;"
  name="builder-form" class="ghl-survey-form" data-v-fd05e6d5=""><!---->
  <div class="ghl-question-set" style="margin-top:2px;" data-v-fd05e6d5=""><!--[-->
    <div class="ghl-page-current form-builder--wrap-questions ghl-question" data-v-fd05e6d5="">
      <div class="fields-container row" data-v-fd05e6d5=""><!--[-->
        <div class="col-12" data-v-fd05e6d5="">
          <div class="f-even form-field-container" data-v-fd05e6d5="">
            <div data-v-fd05e6d5="">
              <div class="field-container">
                <div id="form-first_name" class="form-builder--item-input form-builder--item"><!----><label>First Name <span>*</span></label><input type="text" placeholder="First Name" name="first_name" class="form-control" id="first_name"
                    data-required="true"><!----><!----><!----></div>
              </div>
            </div><!---->
            <div class="field-divider" data-v-fd05e6d5=""></div>
          </div>
        </div>
        <div class="col-12" data-v-fd05e6d5="">
          <div class="f-odd form-field-container" data-v-fd05e6d5="">
            <div data-v-fd05e6d5="">
              <div class="field-container">
                <div id="form-last_name" class="form-builder--item-input form-builder--item"><!----><label>Last Name <span>*</span></label><input type="text" placeholder="Last Name" name="last_name" class="form-control" id="last_name"
                    data-required="true"><!----><!----><!----></div>
              </div>
            </div><!---->
            <div class="field-divider" data-v-fd05e6d5=""></div>
          </div>
        </div>
        <div class="col-12" data-v-fd05e6d5="">
          <div class="f-even form-field-container" data-v-fd05e6d5="">
            <div data-v-fd05e6d5="">
              <div class="field-container">
                <div id="form-address" class="form-builder--item-input form-builder--item"><!----><label>Mailing Address <span>*</span></label><input type="text" placeholder="Address" name="address" class="form-control" id="address"
                    data-required="true"><!----><!----><!----></div>
              </div>
            </div><!---->
            <div class="field-divider" data-v-fd05e6d5=""></div>
          </div>
        </div>
        <div class="col-12" data-v-fd05e6d5="">
          <div class="f-odd form-field-container" data-v-fd05e6d5="">
            <div data-v-fd05e6d5="">
              <div class="field-container">
                <div id="form-city" class="form-builder--item-input form-builder--item"><!----><label>City <span>*</span></label><input type="text" placeholder="City" name="city" class="form-control" id="city"
                    data-required="true"><!----><!----><!----></div>
              </div>
            </div><!---->
            <div class="field-divider" data-v-fd05e6d5=""></div>
          </div>
        </div>
        <div class="col-12" data-v-fd05e6d5="">
          <div class="f-even form-field-container" data-v-fd05e6d5="">
            <div data-v-fd05e6d5="">
              <div class="field-container">
                <div id="form-state" class="form-builder--item-input form-builder--item"><!----><label>State <span>*</span></label><input type="text" placeholder="State" name="state" class="form-control" id="state"
                    data-required="true"><!----><!----><!----></div>
              </div>
            </div><!---->
            <div class="field-divider" data-v-fd05e6d5=""></div>
          </div>
        </div>
        <div class="col-12" data-v-fd05e6d5="">
          <div class="f-odd form-field-container" data-v-fd05e6d5="">
            <div data-v-fd05e6d5="">
              <div class="field-container">
                <div id="form-postal_code" class="form-builder--item-input form-builder--item"><!----><label>ZIP code <span>*</span></label><input type="text" placeholder="Postal Code" name="postal_code" class="form-control" id="postal_code"
                    data-required="true"><!----><!----><!----></div>
              </div>
            </div><!---->
            <div class="field-divider" data-v-fd05e6d5=""></div>
          </div>
        </div>
        <div class="col-12" data-v-fd05e6d5="">
          <div class="f-even form-field-container" data-v-fd05e6d5=""><!---->
            <div class="form-builder--item field-container form-builder--item-input" data-v-fd05e6d5=""><!----><label>Email <span>*</span></label>
              <div>
                <div class="flex email-input"><input placeholder="Email" name="email" type="email" class="form-control" data-required="true"><!----></div><!----><!---->
              </div><!----><!----><!---->
            </div>
            <div class="field-divider" data-v-fd05e6d5=""></div>
          </div>
        </div>
        <div class="col-12" data-v-fd05e6d5="">
          <div class="f-odd form-field-container" data-v-fd05e6d5="">
            <div data-v-fd05e6d5="">
              <div class="field-container">
                <div id="form-phone" class="form-builder--item-input form-builder--item"><!----><label>Mobile Phone <span>*</span></label>
                  <div>
                    <div class="flex phone-input" style=""><input type="tel" name="phone" placeholder="Phone" autocomplete="off" class="form-control" id="phone" data-required="true"><!----></div><!----><!---->
                  </div><!----><!----><!---->
                </div>
              </div>
            </div><!---->
            <div class="field-divider" data-v-fd05e6d5=""></div>
          </div>
        </div>
        <div class="col-12" data-v-fd05e6d5="">
          <div class="f-even form-field-container" data-v-fd05e6d5=""><!---->
            <div class="form-builder--item form-builder--item-input" data-v-fd05e6d5=""><!----><label class="field-label">I acknowledge that... <span>*</span></label><!--[-->
              <div style="position:relative;display:inline-block;width:100%;">
                <div class="in-r-c"><input
                    id="The Financial Advisor Training Institute is a Michigan-based school and has complied with the Proprietary Schools Act, Act 148 of 1943 as amended. Their Certificate No. is 8604001533. The Financial Advisor Training Institute is a non-profit, 501(C)3. There is a tuition cost for the program. They do not accept Federal Grants, Veteran benefits, or Federal student loans at this time, but they do offer a discount for current and former military. They DO offer financing from multiple finance companies._LXxMCfOjQqPK59rSxRUf_0_okfs3xw5gi"
                    value="The Financial Advisor Training Institute is a Michigan-based school and has complied with the Proprietary Schools Act, Act 148 of 1943 as amended. Their Certificate No. is 8604001533. The Financial Advisor Training Institute is a non-profit, 501(C)3. There is a tuition cost for the program. They do not accept Federal Grants, Veteran benefits, or Federal student loans at this time, but they do offer a discount for current and former military. They DO offer financing from multiple finance companies."
                    name="The Financial Advisor Training Institute is a Michigan-based school and has complied with the Proprietary Schools Act, Act 148 of 1943 as amended. Their Certificate No. is 8604001533. The Financial Advisor Training Institute is a non-profit, 501(C)3. There is a tuition cost for the program. They do not accept Federal Grants, Veteran benefits, or Federal student loans at this time, but they do offer a discount for current and former military. They DO offer financing from multiple finance companies."
                    type="checkbox" data-q="i_acknowledge_that..." data-required="true"><label style="margin-left:10px;"
                    for="The Financial Advisor Training Institute is a Michigan-based school and has complied with the Proprietary Schools Act, Act 148 of 1943 as amended. Their Certificate No. is 8604001533. The Financial Advisor Training Institute is a non-profit, 501(C)3. There is a tuition cost for the program. They do not accept Federal Grants, Veteran benefits, or Federal student loans at this time, but they do offer a discount for current and former military. They DO offer financing from multiple finance companies._LXxMCfOjQqPK59rSxRUf_0_okfs3xw5gi">The
                    Financial Advisor Training Institute is a Michigan-based school and has complied with the Proprietary Schools Act, Act 148 of 1943 as amended. Their Certificate No. is 8604001533. The Financial Advisor Training Institute is a
                    non-profit, 501(C)3. There is a tuition cost for the program. They do not accept Federal Grants, Veteran benefits, or Federal student loans at this time, but they do offer a discount for current and former military. They DO offer
                    financing from multiple finance companies.</label></div>
              </div><!--]--><!----><!---->
            </div>
            <div class="field-divider" data-v-fd05e6d5=""></div>
          </div>
        </div>
        <div class="col-12" data-v-fd05e6d5="">
          <div class="f-odd form-field-container" data-v-fd05e6d5=""><!---->
            <div class="form-builder--item form-builder--item-input" data-v-fd05e6d5=""><!----><label class="field-label">I also acknowledge that... <span>*</span></label><!--[-->
              <div style="position:relative;display:inline-block;width:100%;">
                <div class="in-r-c"><input
                    id="I am applying for the opportunity to enroll in the Financial Advisor Training Institute training program which will lead to full-time employment after I complete the certification program. I understand that the minimum previous education to be considered is a High School diploma or GED. If I am accepted into the Financial Advisor Training Institute training program, I am aware that I must be sponsored by an F.I.N.R.A. member firm to take the Series 7 exam and the co-requisite Series 66 exam. Our program will provide this for you. Exam sponsorship does not mean Immigrant Visa sponsorship nor does it mean financial sponsorship._mL6vwWl1tvF0PjyG3uGu_0_okfs3xw5gi"
                    value="I am applying for the opportunity to enroll in the Financial Advisor Training Institute training program which will lead to full-time employment after I complete the certification program. I understand that the minimum previous education to be considered is a High School diploma or GED. If I am accepted into the Financial Advisor Training Institute training program, I am aware that I must be sponsored by an F.I.N.R.A. member firm to take the Series 7 exam and the co-requisite Series 66 exam. Our program will provide this for you. Exam sponsorship does not mean Immigrant Visa sponsorship nor does it mean financial sponsorship."
                    name="I am applying for the opportunity to enroll in the Financial Advisor Training Institute training program which will lead to full-time employment after I complete the certification program. I understand that the minimum previous education to be considered is a High School diploma or GED. If I am accepted into the Financial Advisor Training Institute training program, I am aware that I must be sponsored by an F.I.N.R.A. member firm to take the Series 7 exam and the co-requisite Series 66 exam. Our program will provide this for you. Exam sponsorship does not mean Immigrant Visa sponsorship nor does it mean financial sponsorship."
                    type="checkbox" data-q="i_also_acknowledge_that..." data-required="true"><label style="margin-left:10px;"
                    for="I am applying for the opportunity to enroll in the Financial Advisor Training Institute training program which will lead to full-time employment after I complete the certification program. I understand that the minimum previous education to be considered is a High School diploma or GED. If I am accepted into the Financial Advisor Training Institute training program, I am aware that I must be sponsored by an F.I.N.R.A. member firm to take the Series 7 exam and the co-requisite Series 66 exam. Our program will provide this for you. Exam sponsorship does not mean Immigrant Visa sponsorship nor does it mean financial sponsorship._mL6vwWl1tvF0PjyG3uGu_0_okfs3xw5gi">I
                    am applying for the opportunity to enroll in the Financial Advisor Training Institute training program which will lead to full-time employment after I complete the certification program. I understand that the minimum previous
                    education to be considered is a High School diploma or GED. If I am accepted into the Financial Advisor Training Institute training program, I am aware that I must be sponsored by an F.I.N.R.A. member firm to take the Series 7
                    exam and the co-requisite Series 66 exam. Our program will provide this for you. Exam sponsorship does not mean Immigrant Visa sponsorship nor does it mean financial sponsorship.</label></div>
              </div><!--]--><!----><!---->
            </div>
            <div class="field-divider" data-v-fd05e6d5=""></div>
          </div>
        </div>
        <div class="col-12" data-v-fd05e6d5="">
          <div class="f-even form-field-container" data-v-fd05e6d5=""><!---->
            <div class="form-builder--item heading-element" data-v-fd05e6d5="">
              <div class="text-element"
                style="color:#000000;background-color:#FFFFFF;border:0px none #FFFFFF;border-radius:0px;font-family:'roboto';font-size:15px;font-weight:400;text-align:left;padding:0px 20px 0px 20px;box-shadow:0px 0px 0px 0px #FFFFFF;line-height:1.5;">
                <div>
                  <ul>
                    <li>
                      <p style="text-align: center"><strong><em>To advance the page, please use the bottom right hand arrow</em></strong></p>
                    </li>
                  </ul>
                </div>
              </div>
            </div><!---->
          </div>
        </div><!--]-->
      </div>
    </div>
    <div class="form-builder--wrap-questions ghl-question" data-v-fd05e6d5="">
      <div class="fields-container row" data-v-fd05e6d5=""><!--[-->
        <div class="col-12" data-v-fd05e6d5="">
          <div class="f-even form-field-container" data-v-fd05e6d5=""><!---->
            <div class="form-builder--item form-builder--item-input" data-v-fd05e6d5=""><label class="item-description"></label><label class="field-label">Are you a US Citizen or Permanent Resident or are you legally authorized to work in the USA on
                a permanent basis? <span>*</span></label><!--[-->
              <div style="position:relative;display:inline-block;width:100%;" class="option-radio">
                <div style="display:flex;align-items:baseline;margin-bottom:5px;"><input id="Yes_LrsB4zaELMlpmcXW60Ka_0_okfs3xw5gi" value="Yes" type="radio" data-required="true"><label style="margin-left:10px;margin-bottom:0;"
                    for="Yes_LrsB4zaELMlpmcXW60Ka_0_okfs3xw5gi">Yes</label></div>
              </div>
              <div style="position:relative;display:inline-block;width:100%;" class="option-radio">
                <div style="display:flex;align-items:baseline;margin-bottom:5px;"><input id="No_LrsB4zaELMlpmcXW60Ka_1_okfs3xw5gi" value="No" type="radio" data-required="true"><label style="margin-left:10px;margin-bottom:0;"
                    for="No_LrsB4zaELMlpmcXW60Ka_1_okfs3xw5gi">No</label></div>
              </div><!--]--><!----><!----><!---->
            </div><!---->
          </div>
        </div><!--]-->
      </div>
    </div>
    <div class="form-builder--wrap-questions ghl-question" data-v-fd05e6d5="">
      <div class="fields-container row" data-v-fd05e6d5=""><!--[-->
        <div class="col-12" data-v-fd05e6d5="">
          <div class="f-even form-field-container" data-v-fd05e6d5=""><!---->
            <div class="form-builder--item form-builder--item-input" data-v-fd05e6d5=""><label class="item-description"></label><label class="field-label">Have you ever been charged or convicted of a misdemeanor or felony, even if you believe the
                charge/conviction to be expunged? <span>*</span></label><!--[-->
              <div style="position:relative;display:inline-block;width:100%;" class="option-radio">
                <div style="display:flex;align-items:baseline;margin-bottom:5px;"><input id="Yes_gqn8oJYxMPy0rwVGp3Oj_0_okfs3xw5gi" value="Yes" type="radio" data-required="true"><label style="margin-left:10px;margin-bottom:0;"
                    for="Yes_gqn8oJYxMPy0rwVGp3Oj_0_okfs3xw5gi">Yes</label></div>
              </div>
              <div style="position:relative;display:inline-block;width:100%;" class="option-radio">
                <div style="display:flex;align-items:baseline;margin-bottom:5px;"><input id="No_gqn8oJYxMPy0rwVGp3Oj_1_okfs3xw5gi" value="No" type="radio" data-required="true"><label style="margin-left:10px;margin-bottom:0;"
                    for="No_gqn8oJYxMPy0rwVGp3Oj_1_okfs3xw5gi">No</label></div>
              </div><!--]--><!----><!----><!---->
            </div><!---->
          </div>
        </div><!--]-->
      </div>
    </div>
    <div class="form-builder--wrap-questions ghl-question" data-v-fd05e6d5="">
      <div class="fields-container row" data-v-fd05e6d5=""><!--[-->
        <div class="col-12" data-v-fd05e6d5="">
          <div class="f-even form-field-container" data-v-fd05e6d5="">
            <div data-v-fd05e6d5="">
              <div class="field-container">
                <div id="form-hTlw3jAhq4WP63w2TyWJ" class="form-builder--item-input form-builder--item"><label class="item-description"></label><label>Date of Charge(s) or Offense(s) <span>*</span></label><input type="text" placeholder=""
                    name="hTlw3jAhq4WP63w2TyWJ" class="form-control" id="hTlw3jAhq4WP63w2TyWJ" data-required="true"><!----><!----><!----></div>
              </div>
            </div><!----><!---->
          </div>
        </div><!--]-->
      </div>
    </div>
    <div class="form-builder--wrap-questions ghl-question" data-v-fd05e6d5="">
      <div class="fields-container row" data-v-fd05e6d5=""><!--[-->
        <div class="col-12" data-v-fd05e6d5="">
          <div class="f-even form-field-container" data-v-fd05e6d5="">
            <div data-v-fd05e6d5="">
              <div class="field-container">
                <div id="form-1yAEalyNY9VIVvzvGnSH" class="form-builder--item-input form-builder--item"><label class="item-description"></label><label>Please provide details below <span>*</span></label><input type="text" placeholder=""
                    name="1yAEalyNY9VIVvzvGnSH" class="form-control" id="1yAEalyNY9VIVvzvGnSH" data-required="true"><!----><!----><!----></div>
              </div>
            </div><!----><!---->
          </div>
        </div><!--]-->
      </div>
    </div>
    <div class="form-builder--wrap-questions ghl-question" data-v-fd05e6d5="">
      <div class="fields-container row" data-v-fd05e6d5=""><!--[-->
        <div class="col-12" data-v-fd05e6d5="">
          <div class="f-even form-field-container" data-v-fd05e6d5=""><!---->
            <div class="form-builder--item form-builder--item-input" data-v-fd05e6d5=""><label class="item-description"></label><label class="field-label">Level of Offense and Result <span>*</span></label><!--[-->
              <div style="position:relative;display:inline-block;width:100%;" class="option-radio">
                <div style="display:flex;align-items:baseline;margin-bottom:5px;"><input id="Misdemeanor - Not Convicted_fxO19LuP7dTmnpah6GfM_0_okfs3xw5gi" value="Misdemeanor - Not Convicted" type="radio" data-required="true"><label
                    style="margin-left:10px;margin-bottom:0;" for="Misdemeanor - Not Convicted_fxO19LuP7dTmnpah6GfM_0_okfs3xw5gi">Misdemeanor - Not Convicted</label></div>
              </div>
              <div style="position:relative;display:inline-block;width:100%;" class="option-radio">
                <div style="display:flex;align-items:baseline;margin-bottom:5px;"><input id="Misdemeanor - Convicted_fxO19LuP7dTmnpah6GfM_1_okfs3xw5gi" value="Misdemeanor - Convicted" type="radio" data-required="true"><label
                    style="margin-left:10px;margin-bottom:0;" for="Misdemeanor - Convicted_fxO19LuP7dTmnpah6GfM_1_okfs3xw5gi">Misdemeanor - Convicted</label></div>
              </div>
              <div style="position:relative;display:inline-block;width:100%;" class="option-radio">
                <div style="display:flex;align-items:baseline;margin-bottom:5px;"><input id="Felony - Not Convicted_fxO19LuP7dTmnpah6GfM_2_okfs3xw5gi" value="Felony - Not Convicted" type="radio" data-required="true"><label
                    style="margin-left:10px;margin-bottom:0;" for="Felony - Not Convicted_fxO19LuP7dTmnpah6GfM_2_okfs3xw5gi">Felony - Not Convicted</label></div>
              </div>
              <div style="position:relative;display:inline-block;width:100%;" class="option-radio">
                <div style="display:flex;align-items:baseline;margin-bottom:5px;"><input id="Felony - Convicted_fxO19LuP7dTmnpah6GfM_3_okfs3xw5gi" value="Felony - Convicted" type="radio" data-required="true"><label
                    style="margin-left:10px;margin-bottom:0;" for="Felony - Convicted_fxO19LuP7dTmnpah6GfM_3_okfs3xw5gi">Felony - Convicted</label></div>
              </div><!--]--><!----><!----><!---->
            </div><!---->
          </div>
        </div><!--]-->
      </div>
    </div>
    <div class="form-builder--wrap-questions ghl-question" data-v-fd05e6d5="">
      <div class="fields-container row" data-v-fd05e6d5=""><!--[-->
        <div class="col-12" data-v-fd05e6d5="">
          <div class="f-even form-field-container" data-v-fd05e6d5=""><!---->
            <div class="form-builder--item form-builder--item-input" data-v-fd05e6d5=""><label class="item-description"></label><label class="field-label">Within the past 5 years: have you had any past due debts, collections correspondence, made a
                compromise with any creditors, or any charge offs with creditors? . <span>*</span></label><!--[-->
              <div style="position:relative;display:inline-block;width:100%;" class="option-radio">
                <div style="display:flex;align-items:baseline;margin-bottom:5px;"><input id="Yes_gAZ7qp5AKOPvHZgKaxTr_0_okfs3xw5gi" value="Yes" type="radio" data-required="true"><label style="margin-left:10px;margin-bottom:0;"
                    for="Yes_gAZ7qp5AKOPvHZgKaxTr_0_okfs3xw5gi">Yes</label></div>
              </div>
              <div style="position:relative;display:inline-block;width:100%;" class="option-radio">
                <div style="display:flex;align-items:baseline;margin-bottom:5px;"><input id="No_gAZ7qp5AKOPvHZgKaxTr_1_okfs3xw5gi" value="No" type="radio" data-required="true"><label style="margin-left:10px;margin-bottom:0;"
                    for="No_gAZ7qp5AKOPvHZgKaxTr_1_okfs3xw5gi">No</label></div>
              </div><!--]--><!----><!----><!---->
            </div><!---->
          </div>
        </div><!--]-->
      </div>
    </div>
    <div class="form-builder--wrap-questions ghl-question" data-v-fd05e6d5="">
      <div class="fields-container row" data-v-fd05e6d5=""><!--[-->
        <div class="col-12" data-v-fd05e6d5="">
          <div class="f-even form-field-container" data-v-fd05e6d5="">
            <div data-v-fd05e6d5="">
              <div class="field-container">
                <div id="form-Kj7RPRzzgFh0GVRgSu5u" class="form-builder--item-input form-builder--item"><label class="item-description"></label><label>If yes, provide details below please <span>*</span></label><input type="text" placeholder=""
                    name="Kj7RPRzzgFh0GVRgSu5u" class="form-control" id="Kj7RPRzzgFh0GVRgSu5u" data-required="true"><!----><!----><!----></div>
              </div>
            </div><!----><!---->
          </div>
        </div><!--]-->
      </div>
    </div>
    <div class="form-builder--wrap-questions ghl-question" data-v-fd05e6d5="">
      <div class="fields-container row" data-v-fd05e6d5=""><!--[-->
        <div class="col-12" data-v-fd05e6d5="">
          <div class="f-even form-field-container" data-v-fd05e6d5=""><!---->
            <div class="form-builder--item form-builder--item-input" data-v-fd05e6d5=""><label class="item-description"></label><label class="field-label">Within the past 10 years: have you filed a bankruptcy petition or been the subject of an
                involuntary bankruptcy? <span>*</span></label><!--[-->
              <div style="position:relative;display:inline-block;width:100%;" class="option-radio">
                <div style="display:flex;align-items:baseline;margin-bottom:5px;"><input id="Yes_FK0OUFuj2NbY74qOgzI6_0_okfs3xw5gi" value="Yes" type="radio" data-required="true"><label style="margin-left:10px;margin-bottom:0;"
                    for="Yes_FK0OUFuj2NbY74qOgzI6_0_okfs3xw5gi">Yes</label></div>
              </div>
              <div style="position:relative;display:inline-block;width:100%;" class="option-radio">
                <div style="display:flex;align-items:baseline;margin-bottom:5px;"><input id="No_FK0OUFuj2NbY74qOgzI6_1_okfs3xw5gi" value="No" type="radio" data-required="true"><label style="margin-left:10px;margin-bottom:0;"
                    for="No_FK0OUFuj2NbY74qOgzI6_1_okfs3xw5gi">No</label></div>
              </div><!--]--><!----><!----><!---->
            </div><!---->
          </div>
        </div><!--]-->
      </div>
    </div>
    <div class="form-builder--wrap-questions ghl-question" data-v-fd05e6d5="">
      <div class="fields-container row" data-v-fd05e6d5=""><!--[-->
        <div class="col-12" data-v-fd05e6d5="">
          <div class="f-even form-field-container" data-v-fd05e6d5=""><!---->
            <div class="form-builder--item form-builder--item-input" data-v-fd05e6d5=""><label class="item-description"></label><label class="field-label">How long ago was the bankruptcy? <span>*</span></label><!--[-->
              <div style="position:relative;display:inline-block;width:100%;" class="option-radio">
                <div style="display:flex;align-items:baseline;margin-bottom:5px;"><input id="Within the last five years_jEvuAQ8H9ko9bDIpQWip_0_okfs3xw5gi" value="Within the last five years" type="radio" data-required="true"><label
                    style="margin-left:10px;margin-bottom:0;" for="Within the last five years_jEvuAQ8H9ko9bDIpQWip_0_okfs3xw5gi">Within the last five years</label></div>
              </div>
              <div style="position:relative;display:inline-block;width:100%;" class="option-radio">
                <div style="display:flex;align-items:baseline;margin-bottom:5px;"><input id="Five to ten years ago_jEvuAQ8H9ko9bDIpQWip_1_okfs3xw5gi" value="Five to ten years ago" type="radio" data-required="true"><label
                    style="margin-left:10px;margin-bottom:0;" for="Five to ten years ago_jEvuAQ8H9ko9bDIpQWip_1_okfs3xw5gi">Five to ten years ago</label></div>
              </div><!--]--><!----><!----><!---->
            </div><!---->
          </div>
        </div><!--]-->
      </div>
    </div>
    <div class="form-builder--wrap-questions ghl-question" data-v-fd05e6d5="">
      <div class="fields-container row" data-v-fd05e6d5=""><!--[-->
        <div class="col-12" data-v-fd05e6d5="">
          <div class="f-even form-field-container" data-v-fd05e6d5=""><!---->
            <div class="form-builder--item form-builder--item-input" data-v-fd05e6d5=""><label class="item-description"></label><label class="field-label">Was the bankruptcy due to medical debt? <span>*</span></label><!--[-->
              <div style="position:relative;display:inline-block;width:100%;" class="option-radio">
                <div style="display:flex;align-items:baseline;margin-bottom:5px;"><input id="Yes_FxMkpLThYHYZBzxrSch7_0_okfs3xw5gi" value="Yes" type="radio" data-required="true"><label style="margin-left:10px;margin-bottom:0;"
                    for="Yes_FxMkpLThYHYZBzxrSch7_0_okfs3xw5gi">Yes</label></div>
              </div>
              <div style="position:relative;display:inline-block;width:100%;" class="option-radio">
                <div style="display:flex;align-items:baseline;margin-bottom:5px;"><input id="No_FxMkpLThYHYZBzxrSch7_1_okfs3xw5gi" value="No" type="radio" data-required="true"><label style="margin-left:10px;margin-bottom:0;"
                    for="No_FxMkpLThYHYZBzxrSch7_1_okfs3xw5gi">No</label></div>
              </div><!--]--><!----><!----><!---->
            </div><!---->
          </div>
        </div><!--]-->
      </div>
    </div>
    <div class="form-builder--wrap-questions ghl-question" data-v-fd05e6d5="">
      <div class="fields-container row" data-v-fd05e6d5=""><!--[-->
        <div class="col-12" data-v-fd05e6d5="">
          <div class="f-even form-field-container" data-v-fd05e6d5="">
            <div data-v-fd05e6d5="">
              <div class="field-container">
                <div id="form-OB4XhMHYgHkzcBUxBKiF" class="form-builder--item-input form-builder--item"><!----><label>Please provide additional details below <span>*</span></label><input type="text" placeholder="" name="OB4XhMHYgHkzcBUxBKiF"
                    class="form-control" id="OB4XhMHYgHkzcBUxBKiF" data-required="true"><!----><!----><!----></div>
              </div>
            </div><!----><!---->
          </div>
        </div><!--]-->
      </div>
    </div>
    <div class="form-builder--wrap-questions ghl-question" data-v-fd05e6d5="">
      <div class="fields-container row" data-v-fd05e6d5=""><!--[-->
        <div class="col-12" data-v-fd05e6d5="">
          <div class="f-even form-field-container" data-v-fd05e6d5=""><!---->
            <div class="form-builder--item form-builder--item-input" data-v-fd05e6d5=""><label class="item-description"></label><label class="field-label">Within the past 10 years: based upon events that occurred while you exercised control over it,
                has a broker or dealer been the subject of an involuntary bankruptcy petition, or had a trustee appointed, or had a direct payment procedure initiated under the Securities Investor Protection Act? <span>*</span></label><!--[-->
              <div style="position:relative;display:inline-block;width:100%;" class="option-radio">
                <div style="display:flex;align-items:baseline;margin-bottom:5px;"><input id="Yes_5OeIu8U9n5YTuypq9KRx_0_okfs3xw5gi" value="Yes" type="radio" data-required="true"><label style="margin-left:10px;margin-bottom:0;"
                    for="Yes_5OeIu8U9n5YTuypq9KRx_0_okfs3xw5gi">Yes</label></div>
              </div>
              <div style="position:relative;display:inline-block;width:100%;" class="option-radio">
                <div style="display:flex;align-items:baseline;margin-bottom:5px;"><input id="No_5OeIu8U9n5YTuypq9KRx_1_okfs3xw5gi" value="No" type="radio" data-required="true"><label style="margin-left:10px;margin-bottom:0;"
                    for="No_5OeIu8U9n5YTuypq9KRx_1_okfs3xw5gi">No</label></div>
              </div><!--]--><!----><!----><!---->
            </div><!---->
          </div>
        </div><!--]-->
      </div>
    </div>
    <div class="form-builder--wrap-questions ghl-question" data-v-fd05e6d5="">
      <div class="fields-container row" data-v-fd05e6d5=""><!--[-->
        <div class="col-12" data-v-fd05e6d5="">
          <div class="f-even form-field-container" data-v-fd05e6d5="">
            <div data-v-fd05e6d5="">
              <div class="field-container">
                <div id="form-uXav09JIj7JJbKmrE3N5" class="form-builder--item-input form-builder--item"><!----><label>If yes, provide details <span>*</span></label><input type="text" placeholder="" name="uXav09JIj7JJbKmrE3N5" class="form-control"
                    id="uXav09JIj7JJbKmrE3N5" data-required="true"><!----><!----><!----></div>
              </div>
            </div><!----><!---->
          </div>
        </div><!--]-->
      </div>
    </div>
    <div class="form-builder--wrap-questions ghl-question" data-v-fd05e6d5="">
      <div class="fields-container row" data-v-fd05e6d5=""><!--[-->
        <div class="col-12" data-v-fd05e6d5="">
          <div class="f-even form-field-container" data-v-fd05e6d5=""><!---->
            <div class="form-builder--item form-builder--item-input" data-v-fd05e6d5=""><label class="item-description"></label><label class="field-label">Do you have any unsatisfied judgments or liens against you? <span>*</span></label><!--[-->
              <div style="position:relative;display:inline-block;width:100%;" class="option-radio">
                <div style="display:flex;align-items:baseline;margin-bottom:5px;"><input id="Yes_cuCYlzGPTcyVgk0exyOs_0_okfs3xw5gi" value="Yes" type="radio" data-required="true"><label style="margin-left:10px;margin-bottom:0;"
                    for="Yes_cuCYlzGPTcyVgk0exyOs_0_okfs3xw5gi">Yes</label></div>
              </div>
              <div style="position:relative;display:inline-block;width:100%;" class="option-radio">
                <div style="display:flex;align-items:baseline;margin-bottom:5px;"><input id="No_cuCYlzGPTcyVgk0exyOs_1_okfs3xw5gi" value="No" type="radio" data-required="true"><label style="margin-left:10px;margin-bottom:0;"
                    for="No_cuCYlzGPTcyVgk0exyOs_1_okfs3xw5gi">No</label></div>
              </div><!--]--><!----><!----><!---->
            </div><!---->
          </div>
        </div><!--]-->
      </div>
    </div>
    <div class="form-builder--wrap-questions ghl-question" data-v-fd05e6d5="">
      <div class="fields-container row" data-v-fd05e6d5=""><!--[-->
        <div class="col-12" data-v-fd05e6d5="">
          <div class="f-even form-field-container" data-v-fd05e6d5=""><!---->
            <div class="form-builder--item field-container form-builder--item-input" data-v-fd05e6d5=""><label class="item-description"></label><label>If yes, provide details below <span>*</span></label><textarea placeholder=""
                name="3OavRe8PMdgInHRSPXPL" class="form-control" data-required="true"></textarea><!----><!----></div><!---->
          </div>
        </div><!--]-->
      </div>
    </div>
    <div class="form-builder--wrap-questions ghl-question" data-v-fd05e6d5="">
      <div class="fields-container row" data-v-fd05e6d5=""><!--[-->
        <div class="col-12" data-v-fd05e6d5="">
          <div class="f-even form-field-container" data-v-fd05e6d5=""><!---->
            <div class="form-builder--item form-builder--item-input" data-v-fd05e6d5=""><label class="item-description"></label><label class="field-label">How do you consider your credit worthiness? FICO of <span>*</span></label><!--[-->
              <div style="position:relative;display:inline-block;width:100%;" class="option-radio">
                <div style="display:flex;align-items:baseline;margin-bottom:5px;"><input id="Excellent 800-850_7f0g3gDQ1pJWxKXDoPiS_0_okfs3xw5gi" value="Excellent 800-850" type="radio" data-required="true"><label
                    style="margin-left:10px;margin-bottom:0;" for="Excellent 800-850_7f0g3gDQ1pJWxKXDoPiS_0_okfs3xw5gi">Excellent 800-850</label></div>
              </div>
              <div style="position:relative;display:inline-block;width:100%;" class="option-radio">
                <div style="display:flex;align-items:baseline;margin-bottom:5px;"><input id="Very Good 750-799_7f0g3gDQ1pJWxKXDoPiS_1_okfs3xw5gi" value="Very Good 750-799" type="radio" data-required="true"><label
                    style="margin-left:10px;margin-bottom:0;" for="Very Good 750-799_7f0g3gDQ1pJWxKXDoPiS_1_okfs3xw5gi">Very Good 750-799</label></div>
              </div>
              <div style="position:relative;display:inline-block;width:100%;" class="option-radio">
                <div style="display:flex;align-items:baseline;margin-bottom:5px;"><input id="Good 700-749_7f0g3gDQ1pJWxKXDoPiS_2_okfs3xw5gi" value="Good 700-749" type="radio" data-required="true"><label style="margin-left:10px;margin-bottom:0;"
                    for="Good 700-749_7f0g3gDQ1pJWxKXDoPiS_2_okfs3xw5gi">Good 700-749</label></div>
              </div>
              <div style="position:relative;display:inline-block;width:100%;" class="option-radio">
                <div style="display:flex;align-items:baseline;margin-bottom:5px;"><input id="Fair 650-699_7f0g3gDQ1pJWxKXDoPiS_3_okfs3xw5gi" value="Fair 650-699" type="radio" data-required="true"><label style="margin-left:10px;margin-bottom:0;"
                    for="Fair 650-699_7f0g3gDQ1pJWxKXDoPiS_3_okfs3xw5gi">Fair 650-699</label></div>
              </div>
              <div style="position:relative;display:inline-block;width:100%;" class="option-radio">
                <div style="display:flex;align-items:baseline;margin-bottom:5px;"><input id="Poor 600-649_7f0g3gDQ1pJWxKXDoPiS_4_okfs3xw5gi" value="Poor 600-649" type="radio" data-required="true"><label style="margin-left:10px;margin-bottom:0;"
                    for="Poor 600-649_7f0g3gDQ1pJWxKXDoPiS_4_okfs3xw5gi">Poor 600-649</label></div>
              </div>
              <div style="position:relative;display:inline-block;width:100%;" class="option-radio">
                <div style="display:flex;align-items:baseline;margin-bottom:5px;"><input id="Other 300-599_7f0g3gDQ1pJWxKXDoPiS_5_okfs3xw5gi" value="Other 300-599" type="radio" data-required="true"><label style="margin-left:10px;margin-bottom:0;"
                    for="Other 300-599_7f0g3gDQ1pJWxKXDoPiS_5_okfs3xw5gi">Other 300-599</label></div>
              </div><!--]--><!----><!----><!---->
            </div><!---->
          </div>
        </div><!--]-->
      </div>
    </div>
    <div class="form-builder--wrap-questions ghl-question" data-v-fd05e6d5="">
      <div class="fields-container row" data-v-fd05e6d5=""><!--[-->
        <div class="col-12" data-v-fd05e6d5="">
          <div class="f-even form-field-container" data-v-fd05e6d5=""><!---->
            <div class="form-builder--item form-builder--item-input" data-v-fd05e6d5=""><label class="item-description"></label><label class="field-label">Why is your FICO score 599 or below? <span>*</span></label><!--[-->
              <div style="position:relative;display:inline-block;width:100%;" class="option-radio">
                <div style="display:flex;align-items:baseline;margin-bottom:5px;"><input id="Lack of credit history_tju4jas0Ym1BXYDDvvtH_0_okfs3xw5gi" value="Lack of credit history" type="radio" data-required="true"><label
                    style="margin-left:10px;margin-bottom:0;" for="Lack of credit history_tju4jas0Ym1BXYDDvvtH_0_okfs3xw5gi">Lack of credit history</label></div>
              </div>
              <div style="position:relative;display:inline-block;width:100%;" class="option-radio">
                <div style="display:flex;align-items:baseline;margin-bottom:5px;"><input id="Past debt/credit issues_tju4jas0Ym1BXYDDvvtH_1_okfs3xw5gi" value="Past debt/credit issues" type="radio" data-required="true"><label
                    style="margin-left:10px;margin-bottom:0;" for="Past debt/credit issues_tju4jas0Ym1BXYDDvvtH_1_okfs3xw5gi">Past debt/credit issues</label></div>
              </div><!--]--><!----><!----><!---->
            </div><!---->
          </div>
        </div><!--]-->
      </div>
    </div>
    <div class="form-builder--wrap-questions ghl-question" data-v-fd05e6d5="">
      <div class="fields-container row" data-v-fd05e6d5=""><!--[-->
        <div class="col-12" data-v-fd05e6d5="">
          <div class="f-even form-field-container" data-v-fd05e6d5="">
            <div data-v-fd05e6d5="">
              <div class="field-container">
                <div id="form-L9ZMOulM0VNhqBmwAurh" class="form-builder--item-input form-builder--item"><label class="item-description"></label><label>Please provide additional details regarding your credit history (lack of credit or past debt/credit
                    issues) <span>*</span></label><input type="text" placeholder="" name="L9ZMOulM0VNhqBmwAurh" class="form-control" id="L9ZMOulM0VNhqBmwAurh" data-required="true"><!----><!----><!----></div>
              </div>
            </div><!----><!---->
          </div>
        </div><!--]-->
      </div>
    </div>
    <div class="form-builder--wrap-questions ghl-question" data-v-fd05e6d5="">
      <div class="fields-container row" data-v-fd05e6d5=""><!--[-->
        <div class="col-12" data-v-fd05e6d5="">
          <div class="f-even form-field-container" data-v-fd05e6d5=""><!---->
            <div class="form-builder--item form-builder--item-input" data-v-fd05e6d5=""><label class="item-description"></label><label class="field-label">For What Program Are You Applying? <span>*</span></label><!--[-->
              <div style="position:relative;display:inline-block;width:100%;" class="option-radio">
                <div style="display:flex;align-items:baseline;margin-bottom:5px;"><input id="FATI Certification - I need SPONSORSHIP, licensing, and business acceleration_JjgohJLDOILaeOFBegtX_0_okfs3xw5gi"
                    value="FATI Certification - I need SPONSORSHIP, licensing, and business acceleration" type="radio" data-required="true"><label style="margin-left:10px;margin-bottom:0;"
                    for="FATI Certification - I need SPONSORSHIP, licensing, and business acceleration_JjgohJLDOILaeOFBegtX_0_okfs3xw5gi">FATI Certification - I need SPONSORSHIP, licensing, and business acceleration</label></div>
              </div>
              <div style="position:relative;display:inline-block;width:100%;" class="option-radio">
                <div style="display:flex;align-items:baseline;margin-bottom:5px;"><input id="FATI Certification - I need licensing, and business acceleration_JjgohJLDOILaeOFBegtX_1_okfs3xw5gi"
                    value="FATI Certification - I need licensing, and business acceleration" type="radio" data-required="true"><label style="margin-left:10px;margin-bottom:0;"
                    for="FATI Certification - I need licensing, and business acceleration_JjgohJLDOILaeOFBegtX_1_okfs3xw5gi">FATI Certification - I need licensing, and business acceleration</label></div>
              </div>
              <div style="position:relative;display:inline-block;width:100%;" class="option-radio">
                <div style="display:flex;align-items:baseline;margin-bottom:5px;"><input id="FATI Certification - Business Development Only_JjgohJLDOILaeOFBegtX_2_okfs3xw5gi" value="FATI Certification - Business Development Only" type="radio"
                    data-required="true"><label style="margin-left:10px;margin-bottom:0;" for="FATI Certification - Business Development Only_JjgohJLDOILaeOFBegtX_2_okfs3xw5gi">FATI Certification - Business Development Only</label></div>
              </div>
              <div style="position:relative;display:inline-block;width:100%;" class="option-radio">
                <div style="display:flex;align-items:baseline;margin-bottom:5px;"><input id="FATI Certification - Licensing Only (*Admissions Approval Required)_JjgohJLDOILaeOFBegtX_3_okfs3xw5gi"
                    value="FATI Certification - Licensing Only (*Admissions Approval Required)" type="radio" data-required="true"><label style="margin-left:10px;margin-bottom:0;"
                    for="FATI Certification - Licensing Only (*Admissions Approval Required)_JjgohJLDOILaeOFBegtX_3_okfs3xw5gi">FATI Certification - Licensing Only (*Admissions Approval Required)</label></div>
              </div><!--]--><!----><!----><!---->
            </div><!---->
          </div>
        </div><!--]-->
      </div>
    </div>
    <div class="form-builder--wrap-questions ghl-question" data-v-fd05e6d5="">
      <div class="fields-container row" data-v-fd05e6d5=""><!--[-->
        <div class="col-12" data-v-fd05e6d5="">
          <div class="f-even form-field-container" data-v-fd05e6d5=""><!---->
            <div class="form-builder--item form-builder--item-input" data-v-fd05e6d5=""><!----><label class="field-label">Do You Currently Hold Registrations for Life, Health, SIE, Series 6, and/or Series 66? <span>*</span></label><!--[-->
              <div style="position:relative;display:inline-block;width:100%;" class="option-radio">
                <div style="display:flex;align-items:baseline;margin-bottom:5px;"><input id="Yes_ZBalOhj8H3o1RrIKIOBJ_0_okfs3xw5gi" value="Yes" type="radio" data-required="true"><label style="margin-left:10px;margin-bottom:0;"
                    for="Yes_ZBalOhj8H3o1RrIKIOBJ_0_okfs3xw5gi">Yes</label></div>
              </div>
              <div style="position:relative;display:inline-block;width:100%;" class="option-radio">
                <div style="display:flex;align-items:baseline;margin-bottom:5px;"><input id="No_ZBalOhj8H3o1RrIKIOBJ_1_okfs3xw5gi" value="No" type="radio" data-required="true"><label style="margin-left:10px;margin-bottom:0;"
                    for="No_ZBalOhj8H3o1RrIKIOBJ_1_okfs3xw5gi">No</label></div>
              </div><!--]--><!----><!----><!---->
            </div><!---->
          </div>
        </div><!--]-->
      </div>
    </div>
    <div class="form-builder--wrap-questions ghl-question" data-v-fd05e6d5="">
      <div class="fields-container row" data-v-fd05e6d5=""><!--[-->
        <div class="col-12" data-v-fd05e6d5="">
          <div class="f-even form-field-container" data-v-fd05e6d5="">
            <div data-v-fd05e6d5="">
              <div class="field-container">
                <div id="form-ugqpTTKvLy2EOc4OFzyp" class="form-builder--item-input form-builder--item"><label class="item-description"></label><label>Please list the registration(s) you currently hold (Life, Health, SIE, Series 7, and/or Series 66):
                    <span>*</span></label><input type="text" placeholder="" name="ugqpTTKvLy2EOc4OFzyp" class="form-control" id="ugqpTTKvLy2EOc4OFzyp" data-required="true"><!----><!----><!----></div>
              </div>
            </div><!----><!---->
          </div>
        </div><!--]-->
      </div>
    </div>
    <div class="form-builder--wrap-questions ghl-question" data-v-fd05e6d5="">
      <div class="fields-container row" data-v-fd05e6d5=""><!--[-->
        <div class="col-12" data-v-fd05e6d5="">
          <div class="f-even form-field-container" data-v-fd05e6d5=""><!---->
            <div class="form-builder--item form-builder--item-input" data-v-fd05e6d5=""><label class="item-description" for="c83c-873d-NativeDatePicker"></label><label style="" for="c83c-873d-NativeDatePicker" id="c83c-873d-label">Ideally, what date
                would you like to start the course? <span>*</span></label>
              <div class="vdpWithInput vdpComponent date-picker-custom-style date-picker-field-survey" name="NSO3NhxRbr9p15oOojBB"><input value="" placeholder="" type="text" data-required="true"><!----><!----></div><!----><!---->
            </div><!---->
          </div>
        </div><!--]-->
      </div>
    </div>
    <div class="form-builder--wrap-questions ghl-question" data-v-fd05e6d5="">
      <div class="fields-container row" data-v-fd05e6d5=""><!--[-->
        <div class="col-12" data-v-fd05e6d5="">
          <div class="f-even form-field-container" data-v-fd05e6d5="">
            <div data-v-fd05e6d5="">
              <div class="field-container">
                <div id="form-M5H8tDFPDD9oy2PW4kwQ" class="form-builder--item-input form-builder--item"><!----><label>How did you hear about us? <!----></label><input type="text" placeholder="" name="M5H8tDFPDD9oy2PW4kwQ" class="form-control"
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</form>

Text Content

First Name *

Last Name *

Mailing Address *

City *

State *

ZIP code *

Email *


Mobile Phone *


I acknowledge that... *
The Financial Advisor Training Institute is a Michigan-based school and has
complied with the Proprietary Schools Act, Act 148 of 1943 as amended. Their
Certificate No. is 8604001533. The Financial Advisor Training Institute is a
non-profit, 501(C)3. There is a tuition cost for the program. They do not accept
Federal Grants, Veteran benefits, or Federal student loans at this time, but
they do offer a discount for current and former military. They DO offer
financing from multiple finance companies.

I also acknowledge that... *
I am applying for the opportunity to enroll in the Financial Advisor Training
Institute training program which will lead to full-time employment after I
complete the certification program. I understand that the minimum previous
education to be considered is a High School diploma or GED. If I am accepted
into the Financial Advisor Training Institute training program, I am aware that
I must be sponsored by an F.I.N.R.A. member firm to take the Series 7 exam and
the co-requisite Series 66 exam. Our program will provide this for you. Exam
sponsorship does not mean Immigrant Visa sponsorship nor does it mean financial
sponsorship.


 * To advance the page, please use the bottom right hand arrow

Are you a US Citizen or Permanent Resident or are you legally authorized to work
in the USA on a permanent basis? *
Yes
No
Have you ever been charged or convicted of a misdemeanor or felony, even if you
believe the charge/conviction to be expunged? *
Yes
No
Date of Charge(s) or Offense(s) *
Please provide details below *
Level of Offense and Result *
Misdemeanor - Not Convicted
Misdemeanor - Convicted
Felony - Not Convicted
Felony - Convicted
Within the past 5 years: have you had any past due debts, collections
correspondence, made a compromise with any creditors, or any charge offs with
creditors? . *
Yes
No
If yes, provide details below please *
Within the past 10 years: have you filed a bankruptcy petition or been the
subject of an involuntary bankruptcy? *
Yes
No
How long ago was the bankruptcy? *
Within the last five years
Five to ten years ago
Was the bankruptcy due to medical debt? *
Yes
No
Please provide additional details below *
Within the past 10 years: based upon events that occurred while you exercised
control over it, has a broker or dealer been the subject of an involuntary
bankruptcy petition, or had a trustee appointed, or had a direct payment
procedure initiated under the Securities Investor Protection Act? *
Yes
No
If yes, provide details *
Do you have any unsatisfied judgments or liens against you? *
Yes
No
If yes, provide details below *
How do you consider your credit worthiness? FICO of *
Excellent 800-850
Very Good 750-799
Good 700-749
Fair 650-699
Poor 600-649
Other 300-599
Why is your FICO score 599 or below? *
Lack of credit history
Past debt/credit issues
Please provide additional details regarding your credit history (lack of credit
or past debt/credit issues) *
For What Program Are You Applying? *
FATI Certification - I need SPONSORSHIP, licensing, and business acceleration
FATI Certification - I need licensing, and business acceleration
FATI Certification - Business Development Only
FATI Certification - Licensing Only (*Admissions Approval Required)
Do You Currently Hold Registrations for Life, Health, SIE, Series 6, and/or
Series 66? *
Yes
No
Please list the registration(s) you currently hold (Life, Health, SIE, Series 7,
and/or Series 66): *
Ideally, what date would you like to start the course? *

How did you hear about us?
Subscribe to our email newsletter?
Yes, I want to subscribe to your email newsletter.
I understand that withholding information requested on this application or
falsifying information submitted through the application process will make me
ineligible for admission to the institution or subject to dismissal. I certify
that the statements I have made on this application and in all other application
materials submitted are complete and true.
Yes
Student Full Name *

First Name

Middle

Last Name


By submitting this form, I am giving express written consent to receive text
messages and/or telephone calls from or on behalf of the Financial Advisors
Training Institute contacting me about educational opportunities via phone,
including my mobile phone if provided, using an automatic dialer. I understand
that my consent is not a requirement for any purchase.

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Financial Advisor Training Institute, a 501(c)3 Public Charity

3707 West Maple Road Suite 101

Bloomfield Hills, MI 48301



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