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First name *
Last name *
What is your legal name? *
Email *
Phone number *
State/ Region *
Country of Residence * Please Select United States Canada Russia Germany United Kingdom France Italy Spain Ukraine Poland Romania Netherlands Belgium Czechia Greece Portugal Sweden Hungary Belarus Austria Serbia Switzerland Bulgaria Denmark Finland Slovakia Norway Ireland Croatia Moldova Bosnia and Herzegovina Albania Lithuania North Macedonia Slovenia Latvia Kosovo Estonia Montenegro Luxembourg Malta Iceland Andorra Monaco Liechtenstein San Marino Holy See Other
How long have you lived at your current address? *
Your Date of Birth *
Place of Birth *
Please list any colleges/universities attended and degrees earned if applicable (including the year). *
How did you first hear about Keys Collective? *
Do you have a relationship with any current Keys Collective members? If so, please list their name(s). *
What is your primary occupation? *
Company name *
Any Additional Companies? *
What is your current net worth? *
Personal Income - Current Year *
Have you ever served in the military? If so, what branch and when? What is the status of your separation (ex. honorable discharge, less than honorable, dishonorable, etc.)? *
Have you ever had a professional license or certification (such as a law license, real estate, securities, etc.) and what is the status of the license(s)/certification? Did you ever face disciplinary action from a licensing board or other professional body? If so, please describe the situation and outcome. *
Have you or your business ever been named as a defendant in SEC federal court actions or a respondent in an SEC administrative proceeding? If so, please describe the situation and outcome. *
Have you ever been charged or convicted of a felony? If so, please describe the situation and outcome. *
What do you hope to gain from a membership in Keys Collective? *
What unique mindset, skillset or background could you bring to Keys Collective? *
Is there anything else you would like to share about yourself? *
