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FULL DISCLOSURE

The services of providing mutual funds and labour sponsored funds are offered through "3i Financial Investment Services Inc."

The services of providing life insurance and other non-investment plans are offered through "3i Financial Group Inc." Both are separate legal entities.

3i Financial Investment Services Inc. is a member of the Mutual Fund Dealers Association (MFDA) licensed to distribute mutual funds.

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--Contact Information:

Name: (Required)

Please provide "First" and "Last" Name:

Address:

# and Street Name:

City:

Province:

Postal Code:

Main Email Address: (Required)

Telephone Number: (Required)

(Area code) 222-1234

--Professional Information:

Company Name:

Dealer Number:

Agent/Approved Person Code:

Regulators:

Please indicate which governing body your license is attached to:

User Name: (Required)

Preferred User Name for www.supportingadvisors.com

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