2011.1.A - IFSG Referral Nomination Form

REFERRAL PROSPECTIVE CLIENT NOMINATION

When complete, please click "submit" at the bottom of the page - for each referral you make who schedules and keeps an appointment, we will donate $50 to the North Texas Food Bank on your behalf.
SECTION I
Section I requests information about you, the individual MAKING THE REFERRAL.
Your Full Name

First NameLast Name
Your E-mail
Are you currently a client of Integrated Financial Solutions Group?

Other
Your best daytime phone number

Area CodePhone Number
We will be sending the referred individual(s) an email advising them that, The Wealth Code 2.0 - How The Rich Stay Rich in Good Times and Bad is on its way to them. Also, we will provide subsequent informative emails with links to online "Wealth Code" and "IFSG University" resources.

Please be sure to mention to the person you are referring that you have asked your financial advisor to sent them a copy of a book titled, The Wealth Code 2.0 - How The Rich Stay Rich in Good Times and Bad!

Remember for every referral you make (who schedules and keeps an appointment), we will donate $50 to the North Texas Food Bank on your behalf.
SECTION II
Section II requests information about the person whom you are referring.
Referral Prefix (Mr., Mrs., Ms., Dr.)
Referral First Name
Referral Last Name
Referral's cell phone number

Area CodePhone Number
Referral's home phone number

Area CodePhone Number
Referral's work phone number

Area CodePhone Number
What is the referral's best E-Mail for sending E-Seminar or E-Vite Links?
Please indicate if this is referral's home or work address:
Referral Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Please indicate the nature of your relationship with this individual/household:
What E-Seminar content do you feel will be of greatest interest to this referral?
Will you be informing this referral of your recommendation to our firm?
In your opinion, is this individual/household an "accredited investor" qualifying them to attend additional briefings?
Securities offered through VFG Securities, Inc. (VFG), member FINRA/SIPC, and advisory services through VFG Advisors, Inc. (VFA), a Registered Investment Adviser. VFG/VFA is not affiliated with Integrated Financial Solutions Group (IFSG, Ltd.). Tax and legal services not provided. Please seek professional counsel.
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REFERRAL PROSPECTIVE CLIENT NOMINATION

Section I requests information about you, the individual MAKING THE REFERRAL.

Section II requests information about the person whom you are referring.