Petitioner Profile Form—FINRA Board of Governors Election

Name

Name as you would like it to appear on election-related material

Please select the seat that you are interested in:

Small Firm Seat

Full Term until August 2024

Mid-Size Firm Seat

Full Term until August 2024

Large Firm Seat

Full Term until August 2024

Title

Firm Name

Firm CRD#

Individual CRD#

Street Address

Suite/Floor

City

State

ZIP/Postal Code

Confirm email

Phone

Should you be certified as a candidate in the upcoming election, you will also need to submit a brief biographical profile for inclusion in the Election Notice. Your profile should be limited to approximately 500 words or less and should not include personal information such as family relationships. You can either include this profile in the field below, or submit it via email to the Office of the Corporate Secretary upon your certification. Once your profile is received, the Office of the Corporate Secretary will only make minor edits and formatting changes to your profile, such as font type, capitalization, and spacing.

This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.