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Part I
*1. Please provide the following contact information:
*Full Name:
*Street Address:
*Company:
*City:
*E-mail:
*State/Province:
(ex.GA)
*Work Phone:
(ex. 111-111-1111)
*Zip/Postal code:
FAX:
(ex. 111-111-1111)
*Country:
(ex. USA)

*2. How did you hear about Act4Advisors?


Other:

*3. What broker dealer firm(s) are you affiliated with?


Other:

*4. What are your assets currently under management?

*5. What is your primary business?

*6. How are you normally compensated?

7. Do you prepare tax returns?
Yes
No
   
Part II

*8. What financial software do you use? ( Hit and hold the Ctrl key and select all that applies.)
 
*9. Please select the software you are interested in? ( Hit and hold the Ctrl key and select each that applies.)
 
Part III
10. What version of ACT! do you currently use? ?
11. Have you customized your ACT!?
Yes
No

a. If yes, what fields have you added? (limit to 255 characters)

12. Other Comments or Suggestions?

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