Introducer Application First name* Last name* Email* Phone*Company name* Company registration number* Company registered office address* Company website* What lead types are you initially interested in (select all that apply)?* Life Insurance Health Insurance (private) Health Insurance (corporate) Income Protection Equity Release Mortgages Loans Other What other types of leads are you interested in?*Are you authorised by the FCA?* Yes No What type of FCA authorisation do you have?* Directly Authorised Appointed Representative (AR) Introducer Appointed Representative (IAR) FCA authorisation number* Data protection registration number* What advertising sources will you be using to deliver leads (tick all that apply)?*We do not accept leads sourced from email lists, surveys or incentivised methods. Google Ads (Search) Microsoft Ads (Search) Taboola Outbrain Revcontent Yahoo! Gemini TripleLift Adslib MGID AdNow Nativo Sharethrough Meta TikTok Snapchat Pinterest Twitter Google Display Microsoft Display YouTube Reddit Google Discovery Google AdMob Google Gmail Ads Yahoo! Email (Display) Quora Amazon Ads Other What other advertising platforms do you intend to use?*List all URLs you will be delivering leads from*Are leads delivered in real-time?*Real-time is classed from customer submitting the form to delivery to the VM system within 10 seconds Yes No What data validation do you perform (tick all that apply)? Email verification (user has to confirm code sent to their email) Phone verification (user has to confirm code sent in SMS to their phone) Can you confirm all leads are generated in a compliant manner, with regards to the following (tick to confirm)?* FCA Consumer Duty Financial Services and Markets Act 2000 (FSMA) ASA CAP Codes ICO GDPR ICO PECR Once the lead data is transferred to VM, can you confirm the lead data is immediately deleted and no further processing of the data takes place?*Our introducers are not permitted to retain, contact or market to customers/leads submitted to us. Yes No Unless you are directly authorised by the FCA, do you understand you can only use financial promotions provided by VM in adverts and websites?* Yes No CAPTCHA Address Visionary Markets Ltd, Maghull Business Centre, 1 Liverpool Road North, Maghull, Merseyside, L31 2HB Email info@visionarymarkets .com Phone Number Office: 01704 369 886Freephone: 0800 211 8614
