{"id":1522,"date":"2023-05-08T20:03:15","date_gmt":"2023-05-09T00:03:15","guid":{"rendered":"https:\/\/forms.csi.ca\/?page_id=1522"},"modified":"2026-09-03T10:11:06","modified_gmt":"2026-09-03T14:11:06","slug":"z-test-designation-application-designated-financial-services-advisor-dfsa","status":"publish","type":"page","link":"https:\/\/forms.csi.ca\/?page_id=1522","title":{"rendered":"Z-test-Designation Application Designated Financial Services Advisor (DFSA\u2122)"},"content":{"rendered":"<div class=\"wpforms-container wpforms-container-full wpforms-container-save-resume wpforms-block\" id=\"wpforms-1520\"><form id=\"wpforms-form-1520\" class=\"wpforms-validate wpforms-form wpforms-ajax-form\" data-formid=\"1520\" method=\"post\" enctype=\"multipart\/form-data\" action=\"\/index.php?rest_route=%2Fwp%2Fv2%2Fpages%2F1522&#038;wpforms_form_id=1520\" data-token=\"cc1d603a2b0c4c6f349cc7ccb54e48ab\" data-token-time=\"1789932097\"><noscript class=\"wpforms-error-noscript\">Please enable JavaScript in your browser to complete this form.<\/noscript><div class=\"wpforms-field-container\"><div id=\"wpforms-1520-field_41-container\" class=\"wpforms-field wpforms-field-divider\" data-field-type=\"divider\" data-field-id=\"41\"><h3 id=\"wpforms-1520-field_41\">PERSONAL INFORMATION<\/h3><\/div><div id=\"wpforms-1520-field_1-container\" class=\"wpforms-field wpforms-field-number wpforms-one-half wpforms-first\" data-field-type=\"number\" data-field-id=\"1\"><label class=\"wpforms-field-label\" for=\"wpforms-1520-field_1\">Student ID <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"number\" id=\"wpforms-1520-field_1\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][1]\" step=\"any\" required><\/div><div id=\"wpforms-1520-field_32-container\" class=\"wpforms-field wpforms-field-date-time wpforms-one-half\" data-field-type=\"date-time\" data-field-id=\"32\"><label class=\"wpforms-field-label\">Identity Verification Birthdate <span class=\"wpforms-required-label\">*<\/span><\/label><div class=\"wpforms-field-date-dropdown-wrap wpforms-field-small\"><select name=\"wpforms[fields][32][date][d]\" id=\"wpforms-1520-field_32-day\" class=\"wpforms-field-date-time-date-day wpforms-field-required\"  required><option value=\"\" class=\"placeholder\" selected disabled>DD<\/option><option value=\"1\" >1<\/option><option value=\"2\" >2<\/option><option value=\"3\" >3<\/option><option value=\"4\" >4<\/option><option value=\"5\" >5<\/option><option value=\"6\" >6<\/option><option value=\"7\" >7<\/option><option value=\"8\" >8<\/option><option value=\"9\" >9<\/option><option value=\"10\" >10<\/option><option value=\"11\" >11<\/option><option value=\"12\" >12<\/option><option value=\"13\" >13<\/option><option value=\"14\" >14<\/option><option value=\"15\" >15<\/option><option value=\"16\" >16<\/option><option value=\"17\" >17<\/option><option value=\"18\" >18<\/option><option value=\"19\" >19<\/option><option value=\"20\" >20<\/option><option value=\"21\" >21<\/option><option value=\"22\" >22<\/option><option value=\"23\" >23<\/option><option value=\"24\" >24<\/option><option value=\"25\" >25<\/option><option value=\"26\" >26<\/option><option value=\"27\" >27<\/option><option value=\"28\" >28<\/option><option value=\"29\" >29<\/option><option value=\"30\" >30<\/option><option value=\"31\" >31<\/option><\/select><select name=\"wpforms[fields][32][date][m]\" id=\"wpforms-1520-field_32-month\" class=\"wpforms-field-date-time-date-month wpforms-field-required\"  required><option value=\"\" class=\"placeholder\" selected disabled>MM<\/option><option value=\"1\" >1<\/option><option value=\"2\" >2<\/option><option value=\"3\" >3<\/option><option value=\"4\" >4<\/option><option value=\"5\" >5<\/option><option value=\"6\" >6<\/option><option value=\"7\" >7<\/option><option value=\"8\" >8<\/option><option value=\"9\" >9<\/option><option value=\"10\" >10<\/option><option value=\"11\" >11<\/option><option value=\"12\" >12<\/option><\/select><select name=\"wpforms[fields][32][date][y]\" id=\"wpforms-1520-field_32-year\" class=\"wpforms-field-date-time-date-year wpforms-field-required\"  required><option value=\"\" class=\"placeholder\" selected disabled>YYYY<\/option><option value=\"2027\" >2027<\/option><option value=\"2026\" >2026<\/option><option value=\"2025\" >2025<\/option><option value=\"2024\" >2024<\/option><option value=\"2023\" >2023<\/option><option value=\"2022\" >2022<\/option><option value=\"2021\" >2021<\/option><option value=\"2020\" >2020<\/option><option value=\"2019\" >2019<\/option><option value=\"2018\" >2018<\/option><option value=\"2017\" >2017<\/option><option value=\"2016\" >2016<\/option><option value=\"2015\" >2015<\/option><option value=\"2014\" >2014<\/option><option value=\"2013\" >2013<\/option><option value=\"2012\" >2012<\/option><option value=\"2011\" >2011<\/option><option value=\"2010\" >2010<\/option><option value=\"2009\" >2009<\/option><option value=\"2008\" >2008<\/option><option value=\"2007\" >2007<\/option><option value=\"2006\" >2006<\/option><option value=\"2005\" >2005<\/option><option value=\"2004\" >2004<\/option><option value=\"2003\" >2003<\/option><option value=\"2002\" >2002<\/option><option value=\"2001\" >2001<\/option><option value=\"2000\" >2000<\/option><option value=\"1999\" >1999<\/option><option value=\"1998\" >1998<\/option><option value=\"1997\" >1997<\/option><option value=\"1996\" >1996<\/option><option value=\"1995\" >1995<\/option><option value=\"1994\" >1994<\/option><option value=\"1993\" >1993<\/option><option value=\"1992\" >1992<\/option><option value=\"1991\" >1991<\/option><option value=\"1990\" >1990<\/option><option value=\"1989\" >1989<\/option><option value=\"1988\" >1988<\/option><option value=\"1987\" >1987<\/option><option value=\"1986\" >1986<\/option><option value=\"1985\" >1985<\/option><option value=\"1984\" >1984<\/option><option value=\"1983\" >1983<\/option><option value=\"1982\" >1982<\/option><option value=\"1981\" >1981<\/option><option value=\"1980\" >1980<\/option><option value=\"1979\" >1979<\/option><option value=\"1978\" >1978<\/option><option value=\"1977\" >1977<\/option><option value=\"1976\" >1976<\/option><option value=\"1975\" >1975<\/option><option value=\"1974\" >1974<\/option><option value=\"1973\" >1973<\/option><option value=\"1972\" >1972<\/option><option value=\"1971\" >1971<\/option><option value=\"1970\" >1970<\/option><option value=\"1969\" >1969<\/option><option value=\"1968\" >1968<\/option><option value=\"1967\" >1967<\/option><option value=\"1966\" >1966<\/option><option value=\"1965\" >1965<\/option><option value=\"1964\" >1964<\/option><option value=\"1963\" >1963<\/option><option value=\"1962\" >1962<\/option><option value=\"1961\" >1961<\/option><option value=\"1960\" >1960<\/option><option value=\"1959\" >1959<\/option><option value=\"1958\" >1958<\/option><option value=\"1957\" >1957<\/option><option value=\"1956\" >1956<\/option><option value=\"1955\" >1955<\/option><option value=\"1954\" >1954<\/option><option value=\"1953\" >1953<\/option><option value=\"1952\" >1952<\/option><option value=\"1951\" >1951<\/option><option value=\"1950\" >1950<\/option><option value=\"1949\" >1949<\/option><option value=\"1948\" >1948<\/option><option value=\"1947\" >1947<\/option><option value=\"1946\" >1946<\/option><option value=\"1945\" >1945<\/option><option value=\"1944\" >1944<\/option><option value=\"1943\" >1943<\/option><option value=\"1942\" >1942<\/option><option value=\"1941\" >1941<\/option><option value=\"1940\" >1940<\/option><option value=\"1939\" >1939<\/option><option value=\"1938\" >1938<\/option><option value=\"1937\" >1937<\/option><option value=\"1936\" >1936<\/option><option value=\"1935\" >1935<\/option><option value=\"1934\" >1934<\/option><option value=\"1933\" >1933<\/option><option value=\"1932\" >1932<\/option><option value=\"1931\" >1931<\/option><option value=\"1930\" >1930<\/option><option value=\"1929\" >1929<\/option><option value=\"1928\" >1928<\/option><option value=\"1927\" >1927<\/option><option value=\"1926\" >1926<\/option><option value=\"1925\" >1925<\/option><option value=\"1924\" >1924<\/option><option value=\"1923\" >1923<\/option><option value=\"1922\" >1922<\/option><option value=\"1921\" >1921<\/option><option value=\"1920\" >1920<\/option><\/select><\/div><\/div><div id=\"wpforms-1520-field_3-container\" class=\"wpforms-field wpforms-field-name\" data-field-type=\"name\" data-field-id=\"3\"><label class=\"wpforms-field-label\">Please indicate your name (including any initials used) exactly as it appears on your government-issued photo ID. <span class=\"wpforms-required-label\">*<\/span><\/label><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-first wpforms-two-fifths\"><input type=\"text\" id=\"wpforms-1520-field_3\" class=\"wpforms-field-name-first wpforms-field-required\" name=\"wpforms[fields][3][first]\" required><label for=\"wpforms-1520-field_3\" class=\"wpforms-field-sublabel after\">First<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-fifth\"><input type=\"text\" id=\"wpforms-1520-field_3-middle\" class=\"wpforms-field-name-middle\" name=\"wpforms[fields][3][middle]\" ><label for=\"wpforms-1520-field_3-middle\" class=\"wpforms-field-sublabel after\">Middle<\/label><\/div><div class=\"wpforms-field-row-block wpforms-two-fifths\"><input type=\"text\" id=\"wpforms-1520-field_3-last\" class=\"wpforms-field-name-last wpforms-field-required\" name=\"wpforms[fields][3][last]\" required><label for=\"wpforms-1520-field_3-last\" class=\"wpforms-field-sublabel after\">Last<\/label><\/div><\/div><\/div><div id=\"wpforms-1520-field_4-container\" class=\"wpforms-field wpforms-field-radio wpforms-one-half wpforms-first wpforms-list-inline\" data-field-type=\"radio\" data-field-id=\"4\"><label class=\"wpforms-field-label\">Gender <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-1520-field_4\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-1520-field_4_1\" name=\"wpforms[fields][4]\" value=\"Female\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1520-field_4_1\">Female<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-1520-field_4_2\" name=\"wpforms[fields][4]\" value=\"Male\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1520-field_4_2\">Male<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-1520-field_4_3\" name=\"wpforms[fields][4]\" value=\"Non-Binary\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1520-field_4_3\">Non-Binary<\/label><\/li><\/ul><\/div><div id=\"wpforms-1520-field_28-container\" class=\"wpforms-field wpforms-field-radio wpforms-one-half wpforms-list-inline\" data-field-type=\"radio\" data-field-id=\"28\"><label class=\"wpforms-field-label\">Language preference for communication <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-1520-field_28\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-1520-field_28_1\" name=\"wpforms[fields][28]\" value=\"English\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1520-field_28_1\">English<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-1520-field_28_2\" name=\"wpforms[fields][28]\" value=\"French\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1520-field_28_2\">French<\/label><\/li><\/ul><\/div><div id=\"wpforms-1520-field_7-container\" class=\"wpforms-field wpforms-field-email wpforms-one-half wpforms-first\" data-field-type=\"email\" data-field-id=\"7\"><label class=\"wpforms-field-label\" for=\"wpforms-1520-field_7\">Preferred Email Address <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"email\" id=\"wpforms-1520-field_7\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][7]\" spellcheck=\"false\" required><\/div><div id=\"wpforms-1520-field_8-container\" class=\"wpforms-field wpforms-field-email wpforms-one-half\" data-field-type=\"email\" data-field-id=\"8\"><label class=\"wpforms-field-label\" for=\"wpforms-1520-field_8\">Alternate Email Address<\/label><input type=\"email\" id=\"wpforms-1520-field_8\" class=\"wpforms-field-medium\" name=\"wpforms[fields][8]\" spellcheck=\"false\" ><\/div><div id=\"wpforms-1520-field_117-container\" class=\"wpforms-field wpforms-field-radio wpforms-list-inline wpforms-conditional-trigger\" data-field-type=\"radio\" data-field-id=\"117\"><label class=\"wpforms-field-label\">Phone number to reach you <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-1520-field_117\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-1520-field_117_1\" name=\"wpforms[fields][117]\" value=\"Personal\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1520-field_117_1\">Personal<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-1520-field_117_2\" name=\"wpforms[fields][117]\" value=\"Business\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1520-field_117_2\">Business<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-1520-field_117_3\" name=\"wpforms[fields][117]\" value=\"Both\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1520-field_117_3\">Both<\/label><\/li><\/ul><\/div><div id=\"wpforms-1520-field_21-container\" class=\"wpforms-field wpforms-field-phone wpforms-one-half wpforms-first wpforms-conditional-field wpforms-conditional-show\" data-field-type=\"phone\" data-field-id=\"21\" style=\"display:none;\"><label class=\"wpforms-field-label\" for=\"wpforms-1520-field_21\">Personal Phone <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"tel\" id=\"wpforms-1520-field_21\" class=\"wpforms-field-medium wpforms-field-required wpforms-masked-input\" data-inputmask=\"&#039;mask&#039;: &#039;(999) 999-9999&#039;\" data-rule-us-phone-field=\"true\" data-inputmask-inputmode=\"tel\" name=\"wpforms[fields][21]\" aria-label=\"Personal Phone\" required><\/div><div id=\"wpforms-1520-field_10-container\" class=\"wpforms-field wpforms-field-phone wpforms-one-half wpforms-first wpforms-conditional-field wpforms-conditional-show\" data-field-type=\"phone\" data-field-id=\"10\" style=\"display:none;\"><label class=\"wpforms-field-label\" for=\"wpforms-1520-field_10\">Business Phone <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"tel\" id=\"wpforms-1520-field_10\" class=\"wpforms-field-medium wpforms-field-required wpforms-masked-input\" data-inputmask=\"&#039;mask&#039;: &#039;(999) 999-9999&#039;\" data-rule-us-phone-field=\"true\" data-inputmask-inputmode=\"tel\" name=\"wpforms[fields][10]\" aria-label=\"Business Phone\" required><\/div><div id=\"wpforms-1520-field_118-container\" class=\"wpforms-field wpforms-field-radio wpforms-list-inline wpforms-conditional-trigger\" data-field-type=\"radio\" data-field-id=\"118\"><label class=\"wpforms-field-label\">Address <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-1520-field_118\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-1520-field_118_1\" name=\"wpforms[fields][118]\" value=\"Home Address\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1520-field_118_1\">Home Address<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-1520-field_118_2\" name=\"wpforms[fields][118]\" value=\"Business Address\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1520-field_118_2\">Business Address<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-1520-field_118_3\" name=\"wpforms[fields][118]\" value=\"Both\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1520-field_118_3\">Both<\/label><\/li><\/ul><\/div><div id=\"wpforms-1520-field_14-container\" class=\"wpforms-field wpforms-field-address wpforms-one-half wpforms-first wpforms-conditional-field wpforms-conditional-show\" data-field-type=\"address\" data-field-id=\"14\" style=\"display:none;\"><label class=\"wpforms-field-label\" for=\"wpforms-1520-field_14\">Home Address <span class=\"wpforms-required-label\">*<\/span><\/label><div class=\"wpforms-field-row wpforms-field-large\"><div ><input type=\"text\" id=\"wpforms-1520-field_14\" class=\"wpforms-field-address-address1 wpforms-field-required\" name=\"wpforms[fields][14][address1]\" placeholder=\"Street Address, P.O. box\" required><label for=\"wpforms-1520-field_14\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">Address Line 1<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-large\"><div ><input type=\"text\" id=\"wpforms-1520-field_14-address2\" class=\"wpforms-field-address-address2\" name=\"wpforms[fields][14][address2]\" placeholder=\"Apartment, suite, unit, floor, etc.\" ><label for=\"wpforms-1520-field_14-address2\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">Address Line 2<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-large\"><div class=\"wpforms-field-row-block wpforms-one-half wpforms-first\"><input type=\"text\" id=\"wpforms-1520-field_14-city\" class=\"wpforms-field-address-city wpforms-field-required\" name=\"wpforms[fields][14][city]\" placeholder=\"City\" required><label for=\"wpforms-1520-field_14-city\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">City<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-1520-field_14-state\" class=\"wpforms-field-address-state wpforms-field-required\" name=\"wpforms[fields][14][state]\" placeholder=\"State \/ Province\" required><label for=\"wpforms-1520-field_14-state\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">State \/ Province \/ Region<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-large\"><div class=\"wpforms-field-row-block wpforms-one-half wpforms-first\"><input type=\"text\" id=\"wpforms-1520-field_14-postal\" class=\"wpforms-field-address-postal wpforms-field-required\" name=\"wpforms[fields][14][postal]\" placeholder=\"ZIP \/ Postal\" required><label for=\"wpforms-1520-field_14-postal\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">Postal Code<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><select id=\"wpforms-1520-field_14-country\" class=\"wpforms-field-address-country wpforms-field-required\" name=\"wpforms[fields][14][country]\" required><option class=\"placeholder\" value=\"\" selected disabled>&#8212; Select country &#8212;<\/option><option value=\"AF\" >Afghanistan<\/option><option value=\"AL\" >Albania<\/option><option value=\"DZ\" >Algeria<\/option><option value=\"AS\" >American Samoa<\/option><option value=\"AD\" >Andorra<\/option><option value=\"AO\" >Angola<\/option><option value=\"AI\" >Anguilla<\/option><option value=\"AQ\" >Antarctica<\/option><option value=\"AG\" >Antigua and Barbuda<\/option><option value=\"AR\" >Argentina<\/option><option value=\"AM\" >Armenia<\/option><option value=\"AW\" >Aruba<\/option><option value=\"AU\" >Australia<\/option><option value=\"AT\" >Austria<\/option><option value=\"AZ\" >Azerbaijan<\/option><option value=\"BS\" >Bahamas<\/option><option value=\"BH\" >Bahrain<\/option><option value=\"BD\" >Bangladesh<\/option><option value=\"BB\" >Barbados<\/option><option value=\"BY\" >Belarus<\/option><option value=\"BE\" >Belgium<\/option><option value=\"BZ\" >Belize<\/option><option value=\"BJ\" >Benin<\/option><option value=\"BM\" >Bermuda<\/option><option value=\"BT\" >Bhutan<\/option><option value=\"BO\" >Bolivia (Plurinational State of)<\/option><option value=\"BQ\" >Bonaire, Saint Eustatius and Saba<\/option><option value=\"BA\" >Bosnia and Herzegovina<\/option><option value=\"BW\" >Botswana<\/option><option value=\"BV\" >Bouvet Island<\/option><option value=\"BR\" >Brazil<\/option><option value=\"IO\" >British Indian Ocean Territory<\/option><option value=\"BN\" >Brunei Darussalam<\/option><option value=\"BG\" >Bulgaria<\/option><option value=\"BF\" >Burkina Faso<\/option><option value=\"BI\" >Burundi<\/option><option value=\"CV\" >Cabo Verde<\/option><option value=\"KH\" >Cambodia<\/option><option value=\"CM\" >Cameroon<\/option><option value=\"CA\" >Canada<\/option><option value=\"KY\" >Cayman Islands<\/option><option value=\"CF\" >Central African Republic<\/option><option value=\"TD\" >Chad<\/option><option value=\"CL\" >Chile<\/option><option value=\"CN\" >China<\/option><option value=\"CX\" >Christmas Island<\/option><option value=\"CC\" >Cocos (Keeling) Islands<\/option><option value=\"CO\" >Colombia<\/option><option value=\"KM\" >Comoros<\/option><option value=\"CG\" >Congo<\/option><option value=\"CD\" >Congo (Democratic Republic of the)<\/option><option value=\"CK\" >Cook Islands<\/option><option value=\"CR\" >Costa Rica<\/option><option value=\"HR\" >Croatia<\/option><option value=\"CU\" >Cuba<\/option><option value=\"CW\" >Cura\u00e7ao<\/option><option value=\"CY\" >Cyprus<\/option><option value=\"CZ\" >Czech Republic<\/option><option value=\"CI\" >C\u00f4te d&#039;Ivoire<\/option><option value=\"DK\" >Denmark<\/option><option value=\"DJ\" >Djibouti<\/option><option value=\"DM\" >Dominica<\/option><option value=\"DO\" >Dominican Republic<\/option><option value=\"EC\" >Ecuador<\/option><option value=\"EG\" >Egypt<\/option><option value=\"SV\" >El Salvador<\/option><option value=\"GQ\" >Equatorial Guinea<\/option><option value=\"ER\" >Eritrea<\/option><option value=\"EE\" >Estonia<\/option><option value=\"SZ\" >Eswatini (Kingdom of)<\/option><option value=\"ET\" >Ethiopia<\/option><option value=\"FK\" >Falkland Islands (Malvinas)<\/option><option value=\"FO\" >Faroe Islands<\/option><option value=\"FJ\" >Fiji<\/option><option value=\"FI\" >Finland<\/option><option value=\"FR\" >France<\/option><option value=\"GF\" >French Guiana<\/option><option value=\"PF\" >French Polynesia<\/option><option value=\"TF\" >French Southern Territories<\/option><option value=\"GA\" >Gabon<\/option><option value=\"GM\" >Gambia<\/option><option value=\"GE\" >Georgia<\/option><option value=\"DE\" >Germany<\/option><option value=\"GH\" >Ghana<\/option><option value=\"GI\" >Gibraltar<\/option><option value=\"GR\" >Greece<\/option><option value=\"GL\" >Greenland<\/option><option value=\"GD\" >Grenada<\/option><option value=\"GP\" >Guadeloupe<\/option><option value=\"GU\" >Guam<\/option><option value=\"GT\" >Guatemala<\/option><option value=\"GG\" >Guernsey<\/option><option value=\"GN\" >Guinea<\/option><option value=\"GW\" >Guinea-Bissau<\/option><option value=\"GY\" >Guyana<\/option><option value=\"HT\" >Haiti<\/option><option value=\"HM\" >Heard Island and McDonald Islands<\/option><option value=\"HN\" >Honduras<\/option><option value=\"HK\" >Hong Kong<\/option><option value=\"HU\" >Hungary<\/option><option value=\"IS\" >Iceland<\/option><option value=\"IN\" >India<\/option><option value=\"ID\" >Indonesia<\/option><option value=\"IR\" >Iran (Islamic Republic of)<\/option><option value=\"IQ\" >Iraq<\/option><option value=\"IE\" >Ireland (Republic of)<\/option><option value=\"IM\" >Isle of Man<\/option><option value=\"IL\" >Israel<\/option><option value=\"IT\" >Italy<\/option><option value=\"JM\" >Jamaica<\/option><option value=\"JP\" >Japan<\/option><option value=\"JE\" >Jersey<\/option><option value=\"JO\" >Jordan<\/option><option value=\"KZ\" >Kazakhstan<\/option><option value=\"KE\" >Kenya<\/option><option value=\"KI\" >Kiribati<\/option><option value=\"KP\" >Korea (Democratic People&#039;s Republic of)<\/option><option value=\"KR\" >Korea (Republic of)<\/option><option value=\"XK\" >Kosovo<\/option><option value=\"KW\" >Kuwait<\/option><option value=\"KG\" >Kyrgyzstan<\/option><option value=\"LA\" >Lao People&#039;s Democratic Republic<\/option><option value=\"LV\" >Latvia<\/option><option value=\"LB\" >Lebanon<\/option><option value=\"LS\" >Lesotho<\/option><option value=\"LR\" >Liberia<\/option><option value=\"LY\" >Libya<\/option><option value=\"LI\" >Liechtenstein<\/option><option value=\"LT\" >Lithuania<\/option><option value=\"LU\" >Luxembourg<\/option><option value=\"MO\" >Macao<\/option><option value=\"MG\" >Madagascar<\/option><option value=\"MW\" >Malawi<\/option><option value=\"MY\" >Malaysia<\/option><option value=\"MV\" >Maldives<\/option><option value=\"ML\" >Mali<\/option><option value=\"MT\" >Malta<\/option><option value=\"MH\" >Marshall Islands<\/option><option value=\"MQ\" >Martinique<\/option><option value=\"MR\" >Mauritania<\/option><option value=\"MU\" >Mauritius<\/option><option value=\"YT\" >Mayotte<\/option><option value=\"MX\" >Mexico<\/option><option value=\"FM\" >Micronesia (Federated States of)<\/option><option value=\"MD\" >Moldova (Republic of)<\/option><option value=\"MC\" >Monaco<\/option><option value=\"MN\" >Mongolia<\/option><option value=\"ME\" >Montenegro<\/option><option value=\"MS\" >Montserrat<\/option><option value=\"MA\" >Morocco<\/option><option value=\"MZ\" >Mozambique<\/option><option value=\"MM\" >Myanmar<\/option><option value=\"NA\" >Namibia<\/option><option value=\"NR\" >Nauru<\/option><option value=\"NP\" >Nepal<\/option><option value=\"NL\" >Netherlands<\/option><option value=\"NC\" >New Caledonia<\/option><option value=\"NZ\" >New Zealand<\/option><option value=\"NI\" >Nicaragua<\/option><option value=\"NE\" >Niger<\/option><option value=\"NG\" >Nigeria<\/option><option value=\"NU\" >Niue<\/option><option value=\"NF\" >Norfolk Island<\/option><option value=\"MK\" >North Macedonia (Republic of)<\/option><option value=\"MP\" >Northern Mariana Islands<\/option><option value=\"NO\" >Norway<\/option><option value=\"OM\" >Oman<\/option><option value=\"PK\" >Pakistan<\/option><option value=\"PW\" >Palau<\/option><option value=\"PS\" >Palestine (State of)<\/option><option value=\"PA\" >Panama<\/option><option value=\"PG\" >Papua New Guinea<\/option><option value=\"PY\" >Paraguay<\/option><option value=\"PE\" >Peru<\/option><option value=\"PH\" >Philippines<\/option><option value=\"PN\" >Pitcairn<\/option><option value=\"PL\" >Poland<\/option><option value=\"PT\" >Portugal<\/option><option value=\"PR\" >Puerto Rico<\/option><option value=\"QA\" >Qatar<\/option><option value=\"RO\" >Romania<\/option><option value=\"RU\" >Russian Federation<\/option><option value=\"RW\" >Rwanda<\/option><option value=\"RE\" >R\u00e9union<\/option><option value=\"BL\" >Saint Barth\u00e9lemy<\/option><option value=\"SH\" >Saint Helena, Ascension and Tristan da Cunha<\/option><option value=\"KN\" >Saint Kitts and Nevis<\/option><option value=\"LC\" >Saint Lucia<\/option><option value=\"MF\" >Saint Martin (French part)<\/option><option value=\"PM\" >Saint Pierre and Miquelon<\/option><option value=\"VC\" >Saint Vincent and the Grenadines<\/option><option value=\"WS\" >Samoa<\/option><option value=\"SM\" >San Marino<\/option><option value=\"ST\" >Sao Tome and Principe<\/option><option value=\"SA\" >Saudi Arabia<\/option><option value=\"SN\" >Senegal<\/option><option value=\"RS\" >Serbia<\/option><option value=\"SC\" >Seychelles<\/option><option value=\"SL\" >Sierra Leone<\/option><option value=\"SG\" >Singapore<\/option><option value=\"SX\" >Sint Maarten (Dutch part)<\/option><option value=\"SK\" >Slovakia<\/option><option value=\"SI\" >Slovenia<\/option><option value=\"SB\" >Solomon Islands<\/option><option value=\"SO\" >Somalia<\/option><option value=\"ZA\" >South Africa<\/option><option value=\"GS\" >South Georgia and the South Sandwich Islands<\/option><option value=\"SS\" >South Sudan<\/option><option value=\"ES\" >Spain<\/option><option value=\"LK\" >Sri Lanka<\/option><option value=\"SD\" >Sudan<\/option><option value=\"SR\" >Suriname<\/option><option value=\"SJ\" >Svalbard and Jan Mayen<\/option><option value=\"SE\" >Sweden<\/option><option value=\"CH\" >Switzerland<\/option><option value=\"SY\" >Syrian Arab Republic<\/option><option value=\"TW\" >Taiwan, Republic of China<\/option><option value=\"TJ\" >Tajikistan<\/option><option value=\"TZ\" >Tanzania (United Republic of)<\/option><option value=\"TH\" >Thailand<\/option><option value=\"TL\" >Timor-Leste<\/option><option value=\"TG\" >Togo<\/option><option value=\"TK\" >Tokelau<\/option><option value=\"TO\" >Tonga<\/option><option value=\"TT\" >Trinidad and Tobago<\/option><option value=\"TN\" >Tunisia<\/option><option value=\"TM\" >Turkmenistan<\/option><option value=\"TC\" >Turks and Caicos Islands<\/option><option value=\"TV\" >Tuvalu<\/option><option value=\"TR\" >T\u00fcrkiye<\/option><option value=\"UG\" >Uganda<\/option><option value=\"UA\" >Ukraine<\/option><option value=\"AE\" >United Arab Emirates<\/option><option value=\"GB\" >United Kingdom of Great Britain and Northern Ireland<\/option><option value=\"UM\" >United States Minor Outlying Islands<\/option><option value=\"US\" >United States of America<\/option><option value=\"UY\" >Uruguay<\/option><option value=\"UZ\" >Uzbekistan<\/option><option value=\"VU\" >Vanuatu<\/option><option value=\"VA\" >Vatican City State<\/option><option value=\"VE\" >Venezuela (Bolivarian Republic of)<\/option><option value=\"VN\" >Vietnam<\/option><option value=\"VG\" >Virgin Islands (British)<\/option><option value=\"VI\" >Virgin Islands (U.S.)<\/option><option value=\"WF\" >Wallis and Futuna<\/option><option value=\"EH\" >Western Sahara<\/option><option value=\"YE\" >Yemen<\/option><option value=\"ZM\" >Zambia<\/option><option value=\"ZW\" >Zimbabwe<\/option><option value=\"AX\" >\u00c5land Islands<\/option><\/select><label for=\"wpforms-1520-field_14-country\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">Country<\/label><\/div><\/div><\/div><div id=\"wpforms-1520-field_43-container\" class=\"wpforms-field wpforms-field-number wpforms-one-half wpforms-first wpforms-conditional-field wpforms-conditional-show\" data-field-type=\"number\" data-field-id=\"43\" style=\"display:none;\"><label class=\"wpforms-field-label\" for=\"wpforms-1520-field_43\">Business Branch Transit Number (if applicable)<\/label><input type=\"number\" id=\"wpforms-1520-field_43\" class=\"wpforms-field-medium\" name=\"wpforms[fields][43]\" step=\"any\" ><\/div><div id=\"wpforms-1520-field_44-container\" class=\"wpforms-field wpforms-field-number wpforms-one-half wpforms-conditional-field wpforms-conditional-show\" data-field-type=\"number\" data-field-id=\"44\" style=\"display:none;\"><label class=\"wpforms-field-label\" for=\"wpforms-1520-field_44\">Employee Number<\/label><input type=\"number\" id=\"wpforms-1520-field_44\" class=\"wpforms-field-medium\" name=\"wpforms[fields][44]\" step=\"any\" ><\/div><div id=\"wpforms-1520-field_56-container\" class=\"wpforms-field wpforms-field-number wpforms-one-half wpforms-first wpforms-conditional-field wpforms-conditional-show\" data-field-type=\"number\" data-field-id=\"56\" style=\"display:none;\"><label class=\"wpforms-field-label\" for=\"wpforms-1520-field_56\">Employer<\/label><input type=\"number\" id=\"wpforms-1520-field_56\" class=\"wpforms-field-medium\" name=\"wpforms[fields][56]\" step=\"any\" ><\/div><div id=\"wpforms-1520-field_55-container\" class=\"wpforms-field wpforms-field-number wpforms-one-half wpforms-conditional-field wpforms-conditional-show\" data-field-type=\"number\" data-field-id=\"55\" style=\"display:none;\"><label class=\"wpforms-field-label\" for=\"wpforms-1520-field_55\">Job Title<\/label><input type=\"number\" id=\"wpforms-1520-field_55\" class=\"wpforms-field-medium\" name=\"wpforms[fields][55]\" step=\"any\" ><\/div><div id=\"wpforms-1520-field_11-container\" class=\"wpforms-field wpforms-field-address wpforms-one-half wpforms-first wpforms-conditional-field wpforms-conditional-show\" data-field-type=\"address\" data-field-id=\"11\" style=\"display:none;\"><label class=\"wpforms-field-label\" for=\"wpforms-1520-field_11\">Business Address <span class=\"wpforms-required-label\">*<\/span><\/label><div class=\"wpforms-field-row wpforms-field-large\"><div ><input type=\"text\" id=\"wpforms-1520-field_11\" class=\"wpforms-field-address-address1 wpforms-field-required\" name=\"wpforms[fields][11][address1]\" placeholder=\"Street Address, P.O. box\" required><label for=\"wpforms-1520-field_11\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">Address Line 1<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-large\"><div ><input type=\"text\" id=\"wpforms-1520-field_11-address2\" class=\"wpforms-field-address-address2\" name=\"wpforms[fields][11][address2]\" placeholder=\"Apartment, suite, unit, floor, etc.\" ><label for=\"wpforms-1520-field_11-address2\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">Address Line 2<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-large\"><div class=\"wpforms-field-row-block wpforms-one-half wpforms-first\"><input type=\"text\" id=\"wpforms-1520-field_11-city\" class=\"wpforms-field-address-city wpforms-field-required\" name=\"wpforms[fields][11][city]\" placeholder=\"City\" required><label for=\"wpforms-1520-field_11-city\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">City<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-1520-field_11-state\" class=\"wpforms-field-address-state wpforms-field-required\" name=\"wpforms[fields][11][state]\" placeholder=\"State \/ Province\" required><label for=\"wpforms-1520-field_11-state\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">State \/ Province \/ Region<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-large\"><div class=\"wpforms-field-row-block wpforms-one-half wpforms-first\"><input type=\"text\" id=\"wpforms-1520-field_11-postal\" class=\"wpforms-field-address-postal wpforms-field-required\" name=\"wpforms[fields][11][postal]\" placeholder=\"ZIP \/ Postal\" required><label for=\"wpforms-1520-field_11-postal\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">Postal Code<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><select id=\"wpforms-1520-field_11-country\" class=\"wpforms-field-address-country wpforms-field-required\" name=\"wpforms[fields][11][country]\" required><option class=\"placeholder\" value=\"\" selected disabled>&#8212; Select country &#8212;<\/option><option value=\"AF\" >Afghanistan<\/option><option value=\"AL\" >Albania<\/option><option value=\"DZ\" >Algeria<\/option><option value=\"AS\" >American Samoa<\/option><option value=\"AD\" >Andorra<\/option><option value=\"AO\" >Angola<\/option><option value=\"AI\" >Anguilla<\/option><option value=\"AQ\" >Antarctica<\/option><option value=\"AG\" >Antigua and Barbuda<\/option><option value=\"AR\" >Argentina<\/option><option value=\"AM\" >Armenia<\/option><option value=\"AW\" >Aruba<\/option><option value=\"AU\" >Australia<\/option><option value=\"AT\" >Austria<\/option><option value=\"AZ\" >Azerbaijan<\/option><option value=\"BS\" >Bahamas<\/option><option value=\"BH\" >Bahrain<\/option><option value=\"BD\" >Bangladesh<\/option><option value=\"BB\" >Barbados<\/option><option value=\"BY\" >Belarus<\/option><option value=\"BE\" >Belgium<\/option><option value=\"BZ\" >Belize<\/option><option value=\"BJ\" >Benin<\/option><option value=\"BM\" >Bermuda<\/option><option value=\"BT\" >Bhutan<\/option><option value=\"BO\" >Bolivia (Plurinational State of)<\/option><option value=\"BQ\" >Bonaire, Saint Eustatius and Saba<\/option><option value=\"BA\" >Bosnia and Herzegovina<\/option><option value=\"BW\" >Botswana<\/option><option value=\"BV\" >Bouvet Island<\/option><option value=\"BR\" >Brazil<\/option><option value=\"IO\" >British Indian Ocean Territory<\/option><option value=\"BN\" >Brunei Darussalam<\/option><option value=\"BG\" >Bulgaria<\/option><option value=\"BF\" >Burkina Faso<\/option><option value=\"BI\" >Burundi<\/option><option value=\"CV\" >Cabo Verde<\/option><option value=\"KH\" >Cambodia<\/option><option value=\"CM\" >Cameroon<\/option><option value=\"CA\" >Canada<\/option><option value=\"KY\" >Cayman Islands<\/option><option value=\"CF\" >Central African Republic<\/option><option value=\"TD\" >Chad<\/option><option value=\"CL\" >Chile<\/option><option value=\"CN\" >China<\/option><option value=\"CX\" >Christmas Island<\/option><option value=\"CC\" >Cocos (Keeling) Islands<\/option><option value=\"CO\" >Colombia<\/option><option value=\"KM\" >Comoros<\/option><option value=\"CG\" >Congo<\/option><option value=\"CD\" >Congo (Democratic Republic of the)<\/option><option value=\"CK\" >Cook Islands<\/option><option value=\"CR\" >Costa Rica<\/option><option value=\"HR\" >Croatia<\/option><option value=\"CU\" >Cuba<\/option><option value=\"CW\" >Cura\u00e7ao<\/option><option value=\"CY\" >Cyprus<\/option><option value=\"CZ\" >Czech Republic<\/option><option value=\"CI\" >C\u00f4te d&#039;Ivoire<\/option><option value=\"DK\" >Denmark<\/option><option value=\"DJ\" >Djibouti<\/option><option value=\"DM\" >Dominica<\/option><option value=\"DO\" >Dominican Republic<\/option><option value=\"EC\" >Ecuador<\/option><option value=\"EG\" >Egypt<\/option><option value=\"SV\" >El Salvador<\/option><option value=\"GQ\" >Equatorial Guinea<\/option><option value=\"ER\" >Eritrea<\/option><option value=\"EE\" >Estonia<\/option><option value=\"SZ\" >Eswatini (Kingdom of)<\/option><option value=\"ET\" >Ethiopia<\/option><option value=\"FK\" >Falkland Islands (Malvinas)<\/option><option value=\"FO\" >Faroe Islands<\/option><option value=\"FJ\" >Fiji<\/option><option value=\"FI\" >Finland<\/option><option value=\"FR\" >France<\/option><option value=\"GF\" >French Guiana<\/option><option value=\"PF\" >French Polynesia<\/option><option value=\"TF\" >French Southern Territories<\/option><option value=\"GA\" >Gabon<\/option><option value=\"GM\" >Gambia<\/option><option value=\"GE\" >Georgia<\/option><option value=\"DE\" >Germany<\/option><option value=\"GH\" >Ghana<\/option><option value=\"GI\" >Gibraltar<\/option><option value=\"GR\" >Greece<\/option><option value=\"GL\" >Greenland<\/option><option value=\"GD\" >Grenada<\/option><option value=\"GP\" >Guadeloupe<\/option><option value=\"GU\" >Guam<\/option><option value=\"GT\" >Guatemala<\/option><option value=\"GG\" >Guernsey<\/option><option value=\"GN\" >Guinea<\/option><option value=\"GW\" >Guinea-Bissau<\/option><option value=\"GY\" >Guyana<\/option><option value=\"HT\" >Haiti<\/option><option value=\"HM\" >Heard Island and McDonald Islands<\/option><option value=\"HN\" >Honduras<\/option><option value=\"HK\" >Hong Kong<\/option><option value=\"HU\" >Hungary<\/option><option value=\"IS\" >Iceland<\/option><option value=\"IN\" >India<\/option><option value=\"ID\" >Indonesia<\/option><option value=\"IR\" >Iran (Islamic Republic of)<\/option><option value=\"IQ\" >Iraq<\/option><option value=\"IE\" >Ireland (Republic of)<\/option><option value=\"IM\" >Isle of Man<\/option><option value=\"IL\" >Israel<\/option><option value=\"IT\" >Italy<\/option><option value=\"JM\" >Jamaica<\/option><option value=\"JP\" >Japan<\/option><option value=\"JE\" >Jersey<\/option><option value=\"JO\" >Jordan<\/option><option value=\"KZ\" >Kazakhstan<\/option><option value=\"KE\" >Kenya<\/option><option value=\"KI\" >Kiribati<\/option><option value=\"KP\" >Korea (Democratic People&#039;s Republic of)<\/option><option value=\"KR\" >Korea (Republic of)<\/option><option value=\"XK\" >Kosovo<\/option><option value=\"KW\" >Kuwait<\/option><option value=\"KG\" >Kyrgyzstan<\/option><option value=\"LA\" >Lao People&#039;s Democratic Republic<\/option><option value=\"LV\" >Latvia<\/option><option value=\"LB\" >Lebanon<\/option><option value=\"LS\" >Lesotho<\/option><option value=\"LR\" >Liberia<\/option><option value=\"LY\" >Libya<\/option><option value=\"LI\" >Liechtenstein<\/option><option value=\"LT\" >Lithuania<\/option><option value=\"LU\" >Luxembourg<\/option><option value=\"MO\" >Macao<\/option><option value=\"MG\" >Madagascar<\/option><option value=\"MW\" >Malawi<\/option><option value=\"MY\" >Malaysia<\/option><option value=\"MV\" >Maldives<\/option><option value=\"ML\" >Mali<\/option><option value=\"MT\" >Malta<\/option><option value=\"MH\" >Marshall Islands<\/option><option value=\"MQ\" >Martinique<\/option><option value=\"MR\" >Mauritania<\/option><option value=\"MU\" >Mauritius<\/option><option value=\"YT\" >Mayotte<\/option><option value=\"MX\" >Mexico<\/option><option value=\"FM\" >Micronesia (Federated States of)<\/option><option value=\"MD\" >Moldova (Republic of)<\/option><option value=\"MC\" >Monaco<\/option><option value=\"MN\" >Mongolia<\/option><option value=\"ME\" >Montenegro<\/option><option value=\"MS\" >Montserrat<\/option><option value=\"MA\" >Morocco<\/option><option value=\"MZ\" >Mozambique<\/option><option value=\"MM\" >Myanmar<\/option><option value=\"NA\" >Namibia<\/option><option value=\"NR\" >Nauru<\/option><option value=\"NP\" >Nepal<\/option><option value=\"NL\" >Netherlands<\/option><option value=\"NC\" >New Caledonia<\/option><option value=\"NZ\" >New Zealand<\/option><option value=\"NI\" >Nicaragua<\/option><option value=\"NE\" >Niger<\/option><option value=\"NG\" >Nigeria<\/option><option value=\"NU\" >Niue<\/option><option value=\"NF\" >Norfolk Island<\/option><option value=\"MK\" >North Macedonia (Republic of)<\/option><option value=\"MP\" >Northern Mariana Islands<\/option><option value=\"NO\" >Norway<\/option><option value=\"OM\" >Oman<\/option><option value=\"PK\" >Pakistan<\/option><option value=\"PW\" >Palau<\/option><option value=\"PS\" >Palestine (State of)<\/option><option value=\"PA\" >Panama<\/option><option value=\"PG\" >Papua New Guinea<\/option><option value=\"PY\" >Paraguay<\/option><option value=\"PE\" >Peru<\/option><option value=\"PH\" >Philippines<\/option><option value=\"PN\" >Pitcairn<\/option><option value=\"PL\" >Poland<\/option><option value=\"PT\" >Portugal<\/option><option value=\"PR\" >Puerto Rico<\/option><option value=\"QA\" >Qatar<\/option><option value=\"RO\" >Romania<\/option><option value=\"RU\" >Russian Federation<\/option><option value=\"RW\" >Rwanda<\/option><option value=\"RE\" >R\u00e9union<\/option><option value=\"BL\" >Saint Barth\u00e9lemy<\/option><option value=\"SH\" >Saint Helena, Ascension and Tristan da Cunha<\/option><option value=\"KN\" >Saint Kitts and Nevis<\/option><option value=\"LC\" >Saint Lucia<\/option><option value=\"MF\" >Saint Martin (French part)<\/option><option value=\"PM\" >Saint Pierre and Miquelon<\/option><option value=\"VC\" >Saint Vincent and the Grenadines<\/option><option value=\"WS\" >Samoa<\/option><option value=\"SM\" >San Marino<\/option><option value=\"ST\" >Sao Tome and Principe<\/option><option value=\"SA\" >Saudi Arabia<\/option><option value=\"SN\" >Senegal<\/option><option value=\"RS\" >Serbia<\/option><option value=\"SC\" >Seychelles<\/option><option value=\"SL\" >Sierra Leone<\/option><option value=\"SG\" >Singapore<\/option><option value=\"SX\" >Sint Maarten (Dutch part)<\/option><option value=\"SK\" >Slovakia<\/option><option value=\"SI\" >Slovenia<\/option><option value=\"SB\" >Solomon Islands<\/option><option value=\"SO\" >Somalia<\/option><option value=\"ZA\" >South Africa<\/option><option value=\"GS\" >South Georgia and the South Sandwich Islands<\/option><option value=\"SS\" >South Sudan<\/option><option value=\"ES\" >Spain<\/option><option value=\"LK\" >Sri Lanka<\/option><option value=\"SD\" >Sudan<\/option><option value=\"SR\" >Suriname<\/option><option value=\"SJ\" >Svalbard and Jan Mayen<\/option><option value=\"SE\" >Sweden<\/option><option value=\"CH\" >Switzerland<\/option><option value=\"SY\" >Syrian Arab Republic<\/option><option value=\"TW\" >Taiwan, Republic of China<\/option><option value=\"TJ\" >Tajikistan<\/option><option value=\"TZ\" >Tanzania (United Republic of)<\/option><option value=\"TH\" >Thailand<\/option><option value=\"TL\" >Timor-Leste<\/option><option value=\"TG\" >Togo<\/option><option value=\"TK\" >Tokelau<\/option><option value=\"TO\" >Tonga<\/option><option value=\"TT\" >Trinidad and Tobago<\/option><option value=\"TN\" >Tunisia<\/option><option value=\"TM\" >Turkmenistan<\/option><option value=\"TC\" >Turks and Caicos Islands<\/option><option value=\"TV\" >Tuvalu<\/option><option value=\"TR\" >T\u00fcrkiye<\/option><option value=\"UG\" >Uganda<\/option><option value=\"UA\" >Ukraine<\/option><option value=\"AE\" >United Arab Emirates<\/option><option value=\"GB\" >United Kingdom of Great Britain and Northern Ireland<\/option><option value=\"UM\" >United States Minor Outlying Islands<\/option><option value=\"US\" >United States of America<\/option><option value=\"UY\" >Uruguay<\/option><option value=\"UZ\" >Uzbekistan<\/option><option value=\"VU\" >Vanuatu<\/option><option value=\"VA\" >Vatican City State<\/option><option value=\"VE\" >Venezuela (Bolivarian Republic of)<\/option><option value=\"VN\" >Vietnam<\/option><option value=\"VG\" >Virgin Islands (British)<\/option><option value=\"VI\" >Virgin Islands (U.S.)<\/option><option value=\"WF\" >Wallis and Futuna<\/option><option value=\"EH\" >Western Sahara<\/option><option value=\"YE\" >Yemen<\/option><option value=\"ZM\" >Zambia<\/option><option value=\"ZW\" >Zimbabwe<\/option><option value=\"AX\" >\u00c5land Islands<\/option><\/select><label for=\"wpforms-1520-field_11-country\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">Country<\/label><\/div><\/div><\/div><div id=\"wpforms-1520-field_57-container\" class=\"wpforms-field wpforms-field-radio wpforms-list-inline wpforms-conditional-trigger\" data-field-type=\"radio\" data-field-id=\"57\"><label class=\"wpforms-field-label\">To which address would you like us to send your Certificate <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-1520-field_57\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-1520-field_57_1\" name=\"wpforms[fields][57]\" value=\"Business Address\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1520-field_57_1\">Business Address<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-1520-field_57_2\" name=\"wpforms[fields][57]\" value=\"Home Address\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1520-field_57_2\">Home Address<\/label><\/li><\/ul><\/div><div id=\"wpforms-1520-field_58-container\" class=\"wpforms-field wpforms-field-radio wpforms-list-inline wpforms-conditional-trigger\" data-field-type=\"radio\" data-field-id=\"58\"><label class=\"wpforms-field-label\">Which address would you like listed in our DFSA\u2122 directory? <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-1520-field_58\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-1520-field_58_1\" name=\"wpforms[fields][58]\" value=\"Business Address\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1520-field_58_1\">Business Address<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-1520-field_58_2\" name=\"wpforms[fields][58]\" value=\"Home Address\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1520-field_58_2\">Home Address<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"radio\" id=\"wpforms-1520-field_58_4\" name=\"wpforms[fields][58]\" value=\"I do not wish to have my address listed\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1520-field_58_4\">I do not wish to have my address listed<\/label><\/li><\/ul><\/div><div id=\"wpforms-1520-field_19-container\" class=\"wpforms-field wpforms-field-divider\" data-field-type=\"divider\" data-field-id=\"19\"><h3 id=\"wpforms-1520-field_19\">DFSA\u2122 DECLARATION AND SIGNATURE OF APPLICANT<\/h3><\/div><div id=\"wpforms-1520-field_70-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-type=\"checkbox\" data-field-id=\"70\"><label class=\"wpforms-field-label wpforms-label-hide\">Declare <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-1520-field_70\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-1520-field_70_1\" name=\"wpforms[fields][70][]\" value=\"I declare that I have completed this application as completely as I am able and I hereby apply for the DFSA\u2122 Designation.\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1520-field_70_1\">I declare that I have completed this application as completely as I am able and I hereby apply for the DFSA\u2122 Designation.<\/label><\/li><\/ul><\/div><div id=\"wpforms-1520-field_123-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-type=\"checkbox\" data-field-id=\"123\"><label class=\"wpforms-field-label\">DFSA\u2122 REQUIREMENTS <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-1520-field_123\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-1520-field_123_1\" name=\"wpforms[fields][123][]\" value=\"I declare that I have completed the Investment Funds in Canada or the Canadian Securities Course or the Canadian Investment Funds Course,\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1520-field_123_1\">I declare that I have completed the Investment Funds in Canada or the Canadian Securities Course or the Canadian Investment Funds Course,<\/label><\/li><\/ul><\/div><div id=\"wpforms-1520-field_124-container\" class=\"wpforms-field wpforms-field-divider\" data-field-type=\"divider\" data-field-id=\"124\"><h3 id=\"wpforms-1520-field_124\">Financial Services Regulatory Authority (FSRA) Title Protection Act<\/h3><\/div><div id=\"wpforms-1520-field_81-container\" class=\"wpforms-field wpforms-field-html\" data-field-type=\"html\" data-field-id=\"81\"><div id=\"wpforms-1520-field_81\"><p>\r\nCSI has been approved as a Credentialling Body and the DFSA\u2122 has been approved as a Financial Advisor credential.<br \/>\r\nDFSA\u2122 designation holders who fall under the FSRA Title Protection Act:\r\n<ul>\r\n<li>Reside in Ontario, or<\/li>\r\n<li>Reside outside of Ontario but have clients within Ontario, or<\/li>\r\n<li>Hold out to consumers in Ontario that they have the DFSA\u2122<\/li>\r\n<\/ul><\/p><\/div><\/div><div id=\"wpforms-1520-field_133-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-type=\"checkbox\" data-field-id=\"133\"><label class=\"wpforms-field-label wpforms-label-hide\">I fall under the FSRA Title Protection Act  <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-1520-field_133\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-1520-field_133_1\" name=\"wpforms[fields][133][]\" value=\"I fall under the &lt;i&gt;Financial Professionals Title Protection Act, 2019&lt;\/i&gt; or I adopt, accept and agree to be bound by all of its requirements.\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1520-field_133_1\">I fall under the &lt;i&gt;Financial Professionals Title Protection Act, 2019&lt;\/i&gt; or I adopt, accept and agree to be bound by all of its requirements.<\/label><\/li><\/ul><\/div><div id=\"wpforms-1520-field_134-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-type=\"checkbox\" data-field-id=\"134\"><label class=\"wpforms-field-label wpforms-label-hide\">I fall under the FSRA Title Protection Act agreement <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-1520-field_134\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-1520-field_134_1\" name=\"wpforms[fields][134][]\" value=\"I agree to disclose to clients that I hold the DFSA\u2122 designation in a clear and timely manner\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1520-field_134_1\">I agree to disclose to clients that I hold the DFSA\u2122 designation in a clear and timely manner<\/label><\/li><\/ul><\/div><div id=\"wpforms-1520-field_135-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-type=\"checkbox\" data-field-id=\"135\"><label class=\"wpforms-field-label wpforms-label-hide\">I fall under the FSRA Title Protection Act understand  <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-1520-field_135\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-1520-field_135_1\" name=\"wpforms[fields][135][]\" value=\"I understand that if CSI terminates my license to use the DFSA\u2122 Trademark (see Certification Mark License Agreement just below) I will be advised to discontinue using the Financial Advisor title as use of this title is regulated under the Financial Services Regulatory Authority of Ontario.  Under this regulation, you must hold an accredited financial advisor designation and be in good standing to use the title or similar named title.\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1520-field_135_1\">I understand that if CSI terminates my license to use the DFSA\u2122 Trademark (see Certification Mark License Agreement just below) I will be advised to discontinue using the Financial Advisor title as use of this title is regulated under the Financial Services Regulatory Authority of Ontario.  Under this regulation, you must hold an accredited financial advisor designation and be in good standing to use the title or similar named title.<\/label><\/li><\/ul><\/div><div id=\"wpforms-1520-field_125-container\" class=\"wpforms-field wpforms-field-divider\" data-field-type=\"divider\" data-field-id=\"125\"><h3 id=\"wpforms-1520-field_125\">DFSA\u2122 Post Requirements<\/h3><\/div><div id=\"wpforms-1520-field_126-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-type=\"checkbox\" data-field-id=\"126\"><label class=\"wpforms-field-label wpforms-label-hide\">DFSA\u2122 Post Requirements <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-1520-field_126\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-1520-field_126_1\" name=\"wpforms[fields][126][]\" value=\"If I have not already completed the full DFSA\u2122 post educational path, I am aware that I must meet this education requirement within 2 years (24 months) of being granted the DFSA\u2122 designation. If I do not complete the approved educational path within that time period, the DFSA\u2122 designation will be revoked. For more information see: &lt;a href=&quot;https:\/\/www.csi.ca\/en\/credentials\/dfsa\/&quot; target=&quot;_blank&quot;&gt;https:\/\/www.csi.ca\/en\/credentials\/dfsa\/&lt;\/a&gt;\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1520-field_126_1\">If I have not already completed the full DFSA\u2122 post educational path, I am aware that I must meet this education requirement within 2 years (24 months) of being granted the DFSA\u2122 designation. If I do not complete the approved educational path within that time period, the DFSA\u2122 designation will be revoked. For more information see: &lt;a href=&#8221;https:\/\/www.csi.ca\/en\/credentials\/dfsa\/&#8221; target=&#8221;_blank&#8221;&gt;https:\/\/www.csi.ca\/en\/credentials\/dfsa\/&lt;\/a&gt;<\/label><\/li><\/ul><\/div><div id=\"wpforms-1520-field_127-container\" class=\"wpforms-field wpforms-field-divider\" data-field-type=\"divider\" data-field-id=\"127\"><h3 id=\"wpforms-1520-field_127\">Fit and Proper Requirement<\/h3><\/div><div id=\"wpforms-1520-field_52-container\" class=\"wpforms-field wpforms-field-html\" data-field-type=\"html\" data-field-id=\"52\"><div id=\"wpforms-1520-field_52\"><p>Have you ever been accused of professional misconduct, disciplined or reprimanded by, or had a licence suspended or revoked by, an employer, professional association, regulatory authority (i.e. securities commission, IIROC, MFDA, Insurance Regulator,  or consumer protection legislation?<\/p><\/div><\/div><div id=\"wpforms-1520-field_96-container\" class=\"wpforms-field wpforms-field-radio wpforms-list-inline wpforms-conditional-trigger\" data-field-type=\"radio\" data-field-id=\"96\"><label class=\"wpforms-field-label wpforms-label-hide\">Have you ever been accused of professional misconduct, disciplined or reprimanded by, or had a licence suspended or revoked by, an employer, professional association, regulatory authority (i.e. securities commission, IIROC, MFDA, Insurance Regulator,  or consumer protection legislation?<\/label><ul id=\"wpforms-1520-field_96\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-1520-field_96_1\" name=\"wpforms[fields][96]\" value=\"Yes\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1520-field_96_1\">Yes<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-1520-field_96_2\" name=\"wpforms[fields][96]\" value=\"No\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1520-field_96_2\">No<\/label><\/li><\/ul><\/div><div id=\"wpforms-1520-field_97-container\" class=\"wpforms-field wpforms-field-html\" data-field-type=\"html\" data-field-id=\"97\"><div id=\"wpforms-1520-field_97\"><p>Are you currently bankrupt or have you at any time in the past 5 years been adjudged bankrupt? <\/p><\/div><\/div><div id=\"wpforms-1520-field_98-container\" class=\"wpforms-field wpforms-field-radio wpforms-list-inline wpforms-conditional-trigger\" data-field-type=\"radio\" data-field-id=\"98\"><label class=\"wpforms-field-label wpforms-label-hide\">Are you currently bankrupt or have you at any time in the past 5 years been adjudged bankrupt? <\/label><ul id=\"wpforms-1520-field_98\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-1520-field_98_1\" name=\"wpforms[fields][98]\" value=\"Yes\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1520-field_98_1\">Yes<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-1520-field_98_2\" name=\"wpforms[fields][98]\" value=\"No\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1520-field_98_2\">No<\/label><\/li><\/ul><\/div><div id=\"wpforms-1520-field_99-container\" class=\"wpforms-field wpforms-field-html\" data-field-type=\"html\" data-field-id=\"99\"><div id=\"wpforms-1520-field_99\"><p>Have you ever been convicted of a criminal offence* in any jurisdiction for which a record suspension or a pardon has not been granted?<\/p><\/div><\/div><div id=\"wpforms-1520-field_101-container\" class=\"wpforms-field wpforms-field-radio wpforms-list-inline wpforms-conditional-trigger\" data-field-type=\"radio\" data-field-id=\"101\"><label class=\"wpforms-field-label wpforms-label-hide\">Have you ever been convicted of a criminal offence* in any jurisdiction for which a record suspension or a pardon has not been granted?<\/label><ul id=\"wpforms-1520-field_101\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-1520-field_101_1\" name=\"wpforms[fields][101]\" value=\"Yes\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1520-field_101_1\">Yes<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-1520-field_101_2\" name=\"wpforms[fields][101]\" value=\"No\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1520-field_101_2\">No<\/label><\/li><\/ul><\/div><div id=\"wpforms-1520-field_100-container\" class=\"wpforms-field wpforms-field-html\" data-field-type=\"html\" data-field-id=\"100\"><div id=\"wpforms-1520-field_100\"><p>Have you ever been convicted of an offense under any financial services or consumer protection legislation in any jurisdiction (i.e., laws regulating the sale of securities, insurance, real estate, mortgages, etc.)?<\/p><\/div><\/div><div id=\"wpforms-1520-field_102-container\" class=\"wpforms-field wpforms-field-radio wpforms-list-inline wpforms-conditional-trigger\" data-field-type=\"radio\" data-field-id=\"102\"><label class=\"wpforms-field-label wpforms-label-hide\">Have you ever been convicted of an offense under any financial services or consumer protection legislation in any jurisdiction (i.e., laws regulating the sale of securities, insurance, real estate, mortgages, etc.)?<\/label><ul id=\"wpforms-1520-field_102\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-1520-field_102_1\" name=\"wpforms[fields][102]\" value=\"Yes\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1520-field_102_1\">Yes<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-1520-field_102_2\" name=\"wpforms[fields][102]\" value=\"No\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1520-field_102_2\">No<\/label><\/li><\/ul><\/div><div id=\"wpforms-1520-field_106-container\" class=\"wpforms-field wpforms-field-html\" data-field-type=\"html\" data-field-id=\"106\"><div id=\"wpforms-1520-field_106\"><p>If you have answered &#8220;Yes&#8221; to any of the questions above, please attach all relevant paperwork, including details of any punishment or disciplinary action taken. Any information you provide will collected, stored and used in accordance with applicable law and our privacy policy and will be shared with the Designation Ethics Committee to determine your suitability for the designation.\r\n<\/p><p><\/p><\/div><\/div><div id=\"wpforms-1520-field_107-container\" class=\"wpforms-field wpforms-field-file-upload wpforms-conditional-field wpforms-conditional-show\" data-field-type=\"file-upload\" data-field-id=\"107\" style=\"display:none;\"><label class=\"wpforms-field-label\" for=\"wpforms-1520-field_107\">Please attach all relevant paperwork <span class=\"wpforms-required-label\">*<\/span><\/label><div\n\t\tclass=\"wpforms-uploader wpforms-field-required\"\n\t\tdata-field-id=\"107\"\n\t\tdata-form-id=\"1520\"\n\t\tdata-input-name=\"wpforms_1520_107\"\n\t\tdata-extensions=\"jpg,jpeg,jpe,gif,png,bmp,tiff,tif,webp,avif,ico,heic,heif,heics,heifs,asf,asx,wmv,wmx,wm,avi,divx,mov,qt,mpeg,mpg,mpe,mp4,m4v,ogv,webm,mkv,3gp,3gpp,3g2,3gp2,txt,asc,c,cc,h,srt,csv,tsv,ics,rtx,css,vtt,mp3,m4a,m4b,aac,ra,ram,wav,x-wav,ogg,oga,flac,mid,midi,wma,wax,mka,rtf,pdf,class,tar,zip,gz,gzip,rar,7z,psd,xcf,doc,pot,pps,ppt,wri,xla,xls,xlt,xlw,mpp,docx,docm,dotx,dotm,xlsx,xlsm,xlsb,xltx,xltm,xlam,pptx,pptm,ppsx,ppsm,potx,potm,ppam,sldx,sldm,onetoc,onetoc2,onepkg,oxps,xps,odt,odp,ods,odg,odc,odb,odf,wp,wpd,key,numbers,pages\"\n\t\tdata-max-size=\"52428800\"\n\t\tdata-max-file-number=\"20\"\n\t\tdata-post-max-size=\"52428800\"\n\t\tdata-max-parallel-uploads=\"4\"\n\t\tdata-parallel-uploads=\"true\"\n\t\tdata-file-chunk-size=\"2097152\">\n\t<div class=\"dz-message\">\n\t\t<svg  viewBox=\"0 0 640 640\" focusable=\"false\" data-icon=\"inbox\" width=\"50px\" height=\"50px\" fill=\"currentColor\" aria-hidden=\"true\">\n\t\t\t<path d=\"M352 173.3L352 384C352 401.7 337.7 416 320 416C302.3 416 288 401.7 288 384L288 173.3L246.6 214.7C234.1 227.2 213.8 227.2 201.3 214.7C188.8 202.2 188.8 181.9 201.3 169.4L297.3 73.4C309.8 60.9 330.1 60.9 342.6 73.4L438.6 169.4C451.1 181.9 451.1 202.2 438.6 214.7C426.1 227.2 405.8 227.2 393.3 214.7L352 173.3zM320 464C364.2 464 400 428.2 400 384L480 384C515.3 384 544 412.7 544 448L544 480C544 515.3 515.3 544 480 544L160 544C124.7 544 96 515.3 96 480L96 448C96 412.7 124.7 384 160 384L240 384C240 428.2 275.8 464 320 464zM464 488C477.3 488 488 477.3 488 464C488 450.7 477.3 440 464 440C450.7 440 440 450.7 440 464C440 477.3 450.7 488 464 488z\"\/>\n\t\t<\/svg>\n\n\t\t<span class=\"modern-title\">\n\t\t\t\t\t\t\tDrag &amp; Drop Files, \t\t\t\t<span>Choose Files to Upload<\/span>\n\t\t\t\t\t<\/span>\n\n\t\t\t\t\t<span class=\"modern-hint\">You can upload up to 20 files.<\/span>\n\t\t\t<\/div>\n<\/div>\n\n<input\n\t\ttype=\"text\"\n\t\tautocomplete=\"off\"\n\t\treadonly\n\t\tclass=\"dropzone-input\"\n\t\tstyle=\"position:absolute!important;clip:rect(0,0,0,0)!important;height:1px!important;width:1px!important;border:0!important;overflow:hidden!important;padding:0!important;margin:0!important;\"\n\t\tid=\"wpforms-1520-field_107\"\n\t\tname=\"wpforms_1520_107\" required\t\tvalue=\"\">\n<\/div><div id=\"wpforms-1520-field_130-container\" class=\"wpforms-field wpforms-field-divider\" data-field-type=\"divider\" data-field-id=\"130\"><h3 id=\"wpforms-1520-field_130\">Continuing Education Requirements<\/h3><\/div><div id=\"wpforms-1520-field_108-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-type=\"checkbox\" data-field-id=\"108\"><label class=\"wpforms-field-label wpforms-label-hide\">Continuing Education Requirements <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-1520-field_108\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-1520-field_108_1\" name=\"wpforms[fields][108][]\" value=\"I understand and agree to comply with the DFSA\u2122 Continuing Education (CE) requirements as described on the website. This includes maintaining records of completion and agreement that you may be audited for compliance. Click to view more details regarding &lt;a href=&quot;https:\/\/www.csi.ca\/en\/credentials\/dfsa\/maintenance\/&quot; target=&quot;_blank&quot;&gt;Continuing Education Requirements&lt;\/a&gt;.\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1520-field_108_1\">I understand and agree to comply with the DFSA\u2122 Continuing Education (CE) requirements as described on the website. This includes maintaining records of completion and agreement that you may be audited for compliance. Click to view more details regarding &lt;a href=&#8221;https:\/\/www.csi.ca\/en\/credentials\/dfsa\/maintenance\/&#8221; target=&#8221;_blank&#8221;&gt;Continuing Education Requirements&lt;\/a&gt;.<\/label><\/li><\/ul><div class=\"wpforms-field-description\"><p>You are not required to submit your CE documentation on an annual basis, however a percentage of DFSA holders will be audited for compliance annually.<\/p><\/div><\/div><div id=\"wpforms-1520-field_131-container\" class=\"wpforms-field wpforms-field-divider\" data-field-type=\"divider\" data-field-id=\"131\"><h3 id=\"wpforms-1520-field_131\">Code of Ethics<\/h3><\/div><div id=\"wpforms-1520-field_129-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-type=\"checkbox\" data-field-id=\"129\"><label class=\"wpforms-field-label\">As a DFSA\u2122 designation holder and throughout my annual designation period, I agree that: <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-1520-field_129\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-1520-field_129_1\" name=\"wpforms[fields][129][]\" value=\"I will continue to uphold the &lt;a href=&quot;https:\/\/www.csi.ca\/en\/credentials\/dfsa\/professional-conduct-and-governance\/&quot;  target=&quot;_blank&quot;&gt;DFSA\u2122 Code of Ethics and abide&lt;\/a&gt; by the Ethical Misconduct Process.\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1520-field_129_1\">I will continue to uphold the &lt;a href=&#8221;https:\/\/www.csi.ca\/en\/credentials\/dfsa\/professional-conduct-and-governance\/&#8221;  target=&#8221;_blank&#8221;&gt;DFSA\u2122 Code of Ethics and abide&lt;\/a&gt; by the Ethical Misconduct Process.<\/label><\/li><\/ul><\/div><div id=\"wpforms-1520-field_132-container\" class=\"wpforms-field wpforms-field-divider\" data-field-type=\"divider\" data-field-id=\"132\"><h3 id=\"wpforms-1520-field_132\">Certification Mark License Agreement<\/h3><\/div><div id=\"wpforms-1520-field_53-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-type=\"checkbox\" data-field-id=\"53\"><label class=\"wpforms-field-label wpforms-label-hide\">Certification Mark License Agreement <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-1520-field_53\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-1520-field_53_1\" name=\"wpforms[fields][53][]\" value=\"I understand that CSI grants me license to use the DFSA\u2122 Certification Mark for a one-year term and that if I do not renew my DFSA\u2122 designation, CSI will terminate my license to use the DFSATM Certification Mark. I also agree to notify CSI, without delay, of any circumstances that may affect my ability to continue to fulfill the certification requirements. Click to view the &lt;a href=&quot;https:\/\/www.csi.ca\/en\/credentials\/dfsa\/&quot; target=&quot;_blank&quot;&gt;DFSA\u2122 Certification Mark License Agreement&lt;\/a&gt;.\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1520-field_53_1\">I understand that CSI grants me license to use the DFSA\u2122 Certification Mark for a one-year term and that if I do not renew my DFSA\u2122 designation, CSI will terminate my license to use the DFSATM Certification Mark. I also agree to notify CSI, without delay, of any circumstances that may affect my ability to continue to fulfill the certification requirements. Click to view the &lt;a href=&#8221;https:\/\/www.csi.ca\/en\/credentials\/dfsa\/&#8221; target=&#8221;_blank&#8221;&gt;DFSA\u2122 Certification Mark License Agreement&lt;\/a&gt;.<\/label><\/li><\/ul><\/div><div id=\"wpforms-1520-field_18-container\" class=\"wpforms-field wpforms-field-signature\" data-field-type=\"signature\" data-field-id=\"18\"><label class=\"wpforms-field-label\" for=\"wpforms-1520-field_18\">Signature <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-1520-field_18\" class=\"wpforms-signature-input wpforms-screen-reader-element wpforms-field-required\" data-is-wrapped-field=\"1\" name=\"wpforms[fields][18]\" autocomplete=\"off\" inputmode=\"none\" required><div class=\"wpforms-signature-wrap wpforms-field-row wpforms-field-large\" data-input-method=\"draw\"><canvas class=\"wpforms-signature-canvas\" id=\"wpforms-1520-field_18-signature\" data-color=\"#000000\"><\/canvas><div class=\"wpforms-signature-clear\" title=\"Clear 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