Strategic Sector Selection

Request for Personal and/or Telephone Contact

Please fill-out below the answers to the information requested. Make sure you list your telephone numbers ; residence and/or business, with preference where you would like to be reached If you have a fax or an e/mail address please list that as well.

The information requested is required to initiate a contact. It is not designed to oblige you in any shape or form or to put you on a mailing list. Also at this time it is advisable that you do not list any mutual fund holdings on the internet as this is private and confidential information. Your portfolio holdings will only be discussed by telephone, in person or by confidential fax.

Please go ahead, fill out the form and Let’s Get the Ball Rolling !

Tell Us About Yourself:		Your Spouse ( if applicable ):
Surname :		Surname :
First name(s) :		First name(s):
Date of Birth :		Date of Birth :
Your Address:
Street :
Apt/Suite :
City:
Province:
Postal Code:
Telephone/Fax:
Residence :
Business :
Fax :
Preferred Time :
Electronic Mail:
Email :

Please contact me/us and help me/us assess my/our current mutual funds portfolio according to your sector-balancing criteria.
I/we also like you to send the current issue of Monthly Mutual Fund Notes. ( the Notes are sent monthly to clients and prospective clients at NO charge) .

Note : I feel very strongly about the issue of electronic privacy.
I DO NOT make your name, address, telephone/fax numbers and e/mail address available to anyone else.

Remember to press the "print" button on your browser before submitting this form.

Fax to 1-604-947-9624 or
Email above information to hansmerkelbach@shaw.ca