SIFMA Broker Dealer Membership Application


Do not refresh this page while entering data; content will be lost. Click “Next” to save and continue.
Contact Information For Organization
Full legal name of organization: Corporate headquarters street address:
City:
Country:
State:
Zip/Postal Code: Phone:
Fax: WebSite:
Primary/Proxy Contact
List the contact that will be responsible for introducing SIFMA Membership benefits to his/her colleagues and send across updates to SIFMA Member Engagement team on changes in personnel, or changes of interest.
Office address is the same as corporate headquarters address.
Name: Title:
Department: Address:
City:
Country:
State:
Zip/Postal Code: Phone:
Fax: Email Address:  
Dues Contact
If different from above, please check here .List the contact at your firm that will be responsible for approving Membership fees and /or upgrades. If we should forward the invoice to a person other than the individual approving Membership fees, please note below.
Mailing address is same as organization.
Name: Title:
Department: Address:
City:
Country:
State:
Zip/Postal Code: Phone:
Fax: Email Address:  
General Counsel Contact
If applicable, please check here .List your firm's General Counsel/Head of Regulatory Affairs contact. Please check here if this person would like to be considered for inclusion on SIFMA or AMG's General Counsel Committee.
Mailing address is same as organization.
Name: Title:
Department: Address:
City:
Country:
State:
Zip/Postal Code: Phone:
Fax: Email Address:  
Marketing Contact
If applicable, please check here . List your firm's Marketing contact. Please check here if this contact would like to be keep abreast of Thought Leader Library inclusion/corresponding events and /or Member benefits such as including the SIFMA Member Button on either your firms internet, or intranet.
Mailing address is same as organization.
Name: Title:
Department: Address:
City:
Country:
State:
Zip/Postal Code: Phone:
Fax: Email Address:  
Business Continuity Planning (BCP) Contact
If applicable, please check here List your firm’s BCP contact; mail groups are also permitted. In the event of natural disaster or other unforeseen circumstances affecting operations in global financial hubs, SIFMA and/or the GFMA will communicate critical information with regards to business continuity and contingency plans.
Mailing address is same as organization.
Name: Title:
Department: Address:
City:
Country:
State:
Zip/Postal Code: Phone:
Fax: Email Address:  
Human Resources Contact
If applicable, please check here .List your firm's Human Resources contact
Mailing address is same as organization.
Name: Title:
Department: Address:
City:
Country:
State:
Zip/Postal Code: Phone:
Fax: Email Address:  
Head of Diversity/Diversity Inclusion
If applicable, please check here .List your firm's head of diversity initiatives. Would you like to be contacted to participate in an industry award nomination process for your efforts on diversity and inclusion ? If yes or unsure, please have a SIFMA Membership representative contact the individual listed below.
Mailing address is same as organization.
Name: Title:
Department: Address:
City:
Country:
State:
Zip/Postal Code: Phone:
Fax: Email Address:  

Market Data