Request More Information
Use this form to request more info. A Berthel Fisher recruiter will contact you to discuss the options of working with us. You can also contact us at 800.356.5234 and speak with:
Julie Driscoll, Executive Vice President - Business Development, jdriscoll@berthel.com or Recruiting/Transition Coordinator Susan Marshall - smarshall@berthel.com .
All inquiries are confidential
Your Contact Information
* Denotes Required Fields
* First Name:
* Last Name:
* Address:
* City:
* State: Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
* Zip:
* E-mail:
* Phone:
Fax:
Preferred Method of Contact
May we send information to this mailing address? Yes No
May we email you at this address? Yes No
Are you interested in a home office visit? Yes No
Background Information
How many years have you been in the business?
What was your actual production last year ($)?
What is your Average annual production ($)?
Please Select
$50,000 to $99,999
$100,000 to $199,999
$200,000 to $499,999
$500,000 to $999,999
$1,000,000 +
Who is your current Broker/Dealer?
What Licenses Do You Hold?
Series 6
Series 7
Series 22
Series 24
Series 26
Series 63
Series 65
Series 66
How did you hear about us?
Where did you hear about us?
Please Select
Postcard From Berthel Fisher
Internet Search Engine
News Article
Word Of Mouth
Other - Please List Below
Other
Magazine Advertisement
Please Select
Financial Advisor
Financial Planning
Investment Advisor
Investment News
Registered Rep
Research
A Referral?
Please Select
Berthel Rep
Investment Company
Clearing Firm: First Clearing
Clearing Firm: National Financial
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