make('offerings.registration.left_nav', array_except(get_defined_vars(), array('__data', '__path')))->render(); ?>

'folio_form')); ?> 'put', 'id' => 'folio_form')); ?> has()): ?>

all() as $row): ?>

Open an Account: Personal Information

All fields are required, unless marked (optional).

Title (optional)

'Dr.', 'Ms.' => 'Ms.', 'Miss' => 'Miss', 'Mr.' => 'Mr.', 'Mrs.' => 'Mrs.'), null, array('id' => 'user-title', 'class' => 'form-control')); ?> title; ?>

First Name

firstName; ?>

middleName)): ?>

Middle Initial

middleName)): ?> '1', 'class' => 'form-control', 'id' => 'first-name')); ?> middleName; ?>

Last Name

'35', 'class' => 'form-control', 'id' => 'last-name', 'placeholder' => 'Last Name')); ?> lastName; ?>

suffix)): ?>

Suffix (optional)

suffix)): ?> '--', 'Jr.' => 'Jr.', 'Sr.' => 'Sr.', 'II' => 'II', 'III' => 'III', 'IV' => 'IV'), null, array('id' => 'suffix', 'class' => 'form-control')); ?> suffix; ?>

Date of birth

dateOfBirth)): ?>

'2', 'class' => 'form-control', 'id' => 'month', 'placeholder' => 'MM')); ?>

'2', 'class' => 'form-control', 'id' => 'day', 'placeholder' => 'DD')); ?>

'4', 'class' => 'form-control', 'id' => 'year', 'placeholder' => 'YYYY')); ?>

dateOfBirth)); ?>

Social Security Number

tid)): ?>

'3', 'class' => 'form-control', 'id' => 'ssn1', 'placeholder' => 'XXX')); ?>

'2', 'class' => 'form-control', 'id' => 'ssn2', 'placeholder' => 'XX')); ?>

'4', 'class' => 'form-control', 'id' => 'ssn3', 'placeholder' => 'XXXX')); ?>

tid; ?>

E-mail

email1) && Auth::guest()): ?>

email; ?>

Password

Confirm your Password

Evening Phone Number

eveningTelephone)): $eveningTelephone1 = substr($folio->eveningTelephone, 0, 3); $eveningTelephone2 = substr($folio->eveningTelephone, 3, 3); $eveningTelephone3 = substr($folio->eveningTelephone, 6); else: $eveningTelephone1 = null; $eveningTelephone2 = null; $eveningTelephone3 = null; endif; ?>

'3', 'minlength' => '3', 'class' => 'form-control', 'placeholder' => 'XXX', 'data-bv-stringlength' => 'false')); ?>

'4', 'minlength' => '4', 'class' => 'form-control', 'placeholder' => 'XXXX', 'data-bv-stringlength' => 'false')); ?>

Day Phone Number

dayTelephone)): $dayTelephone1 = substr($folio->dayTelephone, 0, 3); $dayTelephone2 = substr($folio->dayTelephone, 3, 3); $dayTelephone3 = substr($folio->dayTelephone, 6); else: $dayTelephone1 = null; $dayTelephone2 = null; $dayTelephone3 = null; endif; ?>

'3', 'minlength' => '3', 'class' => 'form-control', 'placeholder' => 'XXX', 'data-bv-stringlength' => 'false')); ?>

'4', 'minlength' => '4', 'class' => 'form-control', 'placeholder' => 'XXXX', 'data-bv-stringlength' => 'false')); ?>

(Input telephone numbers as numeric characters only. Do not include symbols. Eg: 7032454000 or for extensions: 70324540001234)

Citizenship Status

Select one: citizenship)): ?> citizenship == 'C'); ?> U.S Citizen citizenship == 'R'); ?> Resident Alien U.S Citizen Resident Alien

Primary Address (U.S. Street addresses only; no P.O. Boxes)

Address 1

Address 2 (optional)

City

State

primaryAddress->state)): ?> primaryAddress->state, array('class' => 'form-control')); ?> 'form-control')); ?>

Zip Code

Country: United States

Open an Account: Compliance Information

Securities industry regulations require that we collect all of the information requested in this section to determine investment suitability. It will remain confidential in accordance with our privacy policy.

Employment Information

We are required to record your employment status. Please note, if you're employed (or self-employed) we will also ask for your occupation, as well as employer's name and address.

Status

employmentStatus)): ?> 'Employed', 'Self-Employed' => 'Self-Employed', 'Retired' => 'Retired', 'Student' => 'Student', 'Unemployed' => 'Unemployed', 'Other' => 'Other'), $folio->employmentStatus, array('class' => 'form-control')); ?> 'Employed', 'Self-Employed' => 'Self-Employed', 'Retired' => 'Retired', 'Student' => 'Student', 'Unemployed' => 'Unemployed', 'Other' => 'Other'), null, array('class' => 'form-control')); ?>

Company Name

Address 1

Address 2 (Optional)

City

State

employerAddress->state)): ?> employerAddress->state, array('class' => 'form-control')); ?> 'form-control')); ?>

Zip or Postal Code

Country: United States

General Financial Information

Annual Income

annualIncome)): ?> 'ZERO - $25,000', '2' => '$25,000 - $50,000', '3' => '$50,000 - $100,000', '4' => '$100,000 - $200,000', '5' => '$200,000 - $300,000', '6' => '$300,000 - $500,000', '7' => 'OVER $500,000'), $folio->annualIncome, array('class' => 'form-control', 'id' => 'annual-income')); ?> 'ZERO - $25,000', '2' => '$25,000 - $50,000', '3' => '$50,000 - $100,000', '4' => '$100,000 - $200,000', '5' => '$200,000 - $300,000', '6' => '$300,000 - $500,000', '7' => 'OVER $500,000'), null, array('class' => 'form-control', 'id' => 'annual-income')); ?>

Total Net Worth

netWorth)): ?> 'ZERO - $25,000', '2' => '$25,000 - $50,000', '3' => '$50,000 - $200,000', '4' => '$200,000 - $500,000', '5' => '$500,000 - $1,000,000', '6' => '$1,000,000 - $2,000,000', '7' => '$2,000,000 - $3,000,000', '8' => 'OVER $3,000,000'), $folio->netWorth, array('class' => 'form-control', 'id' => 'total-net-worth')); ?> 'ZERO - $25,000', '2' => '$25,000 - $50,000', '3' => '$50,000 - $200,000', '4' => '$200,000 - $500,000', '5' => '$500,000 - $1,000,000', '6' => '$1,000,000 - $2,000,000', '7' => '$2,000,000 - $3,000,000', '8' => 'OVER $3,000,000'), null, array('class' => 'form-control', 'id' => 'total-net-worth')); ?> (Excluding your home)

Liquid Net Worth

liquidNetWorth)): ?> 'ZERO - $25,000', '2' => '$25,000 - $50,000', '3' => '$50,000 - $200,000', '4' => '$200,000 - $500,000', '5' => '$500,000 - $1,000,000', '6' => '$1,000,000 - $2,000,000', '7' => '$2,000,000 - $3,000,000', '8' => 'OVER $3,000,000'), $folio->liquidNetWorth, array('class' => 'form-control', 'id' => 'liquid-net-worth')); ?> 'ZERO - $25,000', '2' => '$25,000 - $50,000', '3' => '$50,000 - $200,000', '4' => '$200,000 - $500,000', '5' => '$500,000 - $1,000,000', '6' => '$1,000,000 - $2,000,000', '7' => '$2,000,000 - $3,000,000', '8' => 'OVER $3,000,000'), null, array('class' => 'form-control', 'id' => 'liquid-net-worth')); ?> (Cash, securities, etc.)

Are you interested in Private Placement opportunities?

accreditedInvestorNetWorth) && empty($folio->accreditedInvestorAnnualIncome) && empty($folio->previousPrivatePlacementExperience) )?true:false; echo Form::radio('private_placement', '0', $private_placement).' No'; ?> accreditedInvestorNetWorth) || !empty($folio->accreditedInvestorAnnualIncome) || !empty($folio->previousPrivatePlacementExperience) )?true:false; echo Form::radio('private_placement', '1', $private_placement).' Yes'; ?>

You are not required to answer the questions below but you will not be able to participate in private security offerings unless you provide answers.

To determine your "Accredited Investor" status, as defined in Rule 501(a) of Regulation D of the Securities Act of 1933, please answer the following questions:

Are you an individual whose individual Net Worth, or Joint Net Worth with your spouse, exceeds $1,000,000. Excluding the value of your primary residence?

accreditedInvestorNetWorth) && $folio->accreditedInvestorNetWorth === false) ); ?> No accreditedInvestorNetWorth) && $folio->accreditedInvestorNetWorth === true) ); ?> Yes

Have you had individual income in excess of $200,000 in each of the most recent 2 years or joint income with your spouse in excess of $300,000 in each of the same years, and do you reasonably expect to reach the same income level in the current year?

accreditedInvestorAnnualIncome) && $folio->accreditedInvestorAnnualIncome === false) ); ?> No accreditedInvestorAnnualIncome) && $folio->accreditedInvestorAnnualIncome === true) ); ?> Yes

Have you had previous experience investing in Private Placements?

previousPrivatePlacementExperience) && $folio->previousPrivatePlacementExperience === false) ); ?> No previousPrivatePlacementExperience) && $folio->previousPrivatePlacementExperience === true) ); ?> Yes

Compliance Information

Are you or someone in your household or immediate family a 10% shareholder, policymaking officer or member of the board of directors of a publicly traded company?

directorOrTenPercentShareholder) && $folio->directorOrTenPercentShareholder === false) ); ?> No directorOrTenPercentShareholder) && $folio->directorOrTenPercentShareholder === true) ); ?> Yes

Are you, your spoise or any other immediate family members, including parents, in-laws, and siblings that are dependents , employed by or associated with the securities industry (for example, Investment Adviso, Sole Proprieter, Partner, Officer, Director, Branch Manager or Broker at a Broker-Dealer Firm or Municipal Securities Dealer) or a financial regulatory agency, such as FINRA or the New York Stock Exchange? If yes, and if this entity requires that you obtain its approval for to open this account, please select Yes below:

finraAffiliated) && $folio->finraAffiliated === false) ); ?> No finraAffiliated) && $folio->finraAffiliated === true) ); ?> Yes