Global Star Capital - Intermediary / Broker Screening Application
Please complete the form below in full and click submit.  You will be contacted by Global Star Capital Representative who will establish you with directly speaking to our founder Rich Cocovich. It will be assumed that you are ready to move forward and follow our protocol.
First Name:
Last Name:
Address Street 1:
Address Street 2:
City:
Zip Code or Country Code:
State (If Applicable):
Country:
Office Phone:
Cell Phone:
Email:
SKYPE Address:
Company Website Address (if applicable)
Are you a licensed securities broker?  yes or no
Are you or your company (if applicable) financially stable? yes or no
What are your estimated liquid assets at this time?
How long have you been a Broker / Intermediary?
Briefly describe the last one to three projects on which you have worked. Include amount, sector, project location, and project source.
Briefly describe your personal background and / or training in private funding or related fields.
How did you hear about Global Star Capital?
Are you interested in private one on one instruction with our founder, which will require a professional fee to be paid for his time and travel.  This instruction will catapult your business. Please check a box to the right.
I have read the Global Star Capital Web Site and know that I will be contacted by a representative of Global Star Capital as the next step.  I understand that I will not submit projects until I am fully screened and approved by Global Star Capital and will follow their protocol perfectly.   Please use your initials only.
I am aware that Global Star Capital and all of its employees are not licensed securities broker-dealers.
   Please use your initials only.
I understand fully that I will not be working directly for, nor using the Global Star Capital name.   Please use your initials only.
Signature Section
**Please be sure to read the statement below and sign your full name for your application to be accepted and processed**
 
By completing the application above fully as instructed and typing my name (electronic signature) in the space to the right, I understand and am in agreement with the Global Star Capital Process for the Broker / Intermediary program. In addition, I understand that Global Star Capital will review my application and respond to my valid e-mail address under the explained protocol guidelines. Please sign your full name.