Intro Call Registration

Contact Information

Section 1 of 3




Important note: you must use the email address to which your invitation was sent

Work History

Section 2 of 3

Instructions:

Please detail your most recent three [3] years of employment history including any current and former employers.  Click "Add Another" to add additional entries.

IMPORTANT NOTE: Please accurately enter the Start Date and End Date of each full-time position you've held within the past 3 years (please put "1" as the day of the month, if you do not remember; please leave End Date blank if it is a current position).  

If this information is not accurate and complete, it will cause a delay in processing your registration.

Company Name Job Title Start Date End Date
Format: mm/dd/yyyy
Format: mm/dd/yyyy
Add Another

 

(Optional) To make the intro call as productive as possible, so our client can easily understand your perspective in the industry, which publicly-traded companies are most comparable to your company? (you can list a few here, if any)

Terms and Conditions

Section 3 of 3

Instructions:

Please scroll to the bottom of the page to submit this form.

You will be emailed a copy of this agreement for your records, when you submit your registration.


Mosaic Research Management, LLC - Intro Call Terms 

You acknowledge that you have agreed to be engaged by Mosaic Research Management, LLC (“MRM”), and potentially by a client of MRM, for an introductory telephone conversation (or in-person meeting, “intro call”) to gauge the efficacy of a potential consulting relationship with MRM or with an MRM client. You further acknowledge that, in connection with such engagement, MRM and its clients may rely on the acknowledgements and undertakings set forth below. 

1. Confidentiality: You acknowledge that MRM’s clients are in the business of investing and trading in securities. You shall keep confidential your engagement with MRM and its clients, and the information (including the content and substance of any information or opinion) that you transmit to MRM or its clients. In addition, you shall keep confidential and not use any information disclosed to you by or on behalf of MRM or its clients. 

2. Conflict of Interest: You agree to decline participation in this or any consultation with MRM or its clients that presents or may present a conflict of interest or an appearance of a conflict of interest. Such conflicts include any activity that may violate an obligation that you may have to any other person, including any employer, self-regulatory organization or professional association. In addition, you represent that, if you decide to move forward with a formal consulting relationship with MRM or its clients, you are not subject to an employment contract or non-disclosure agreement with any company including your current employer (if you are currently employed) which would prevent you from engaging in a consulting relationship with MRM or its clients. You agree to notify MRM in writing prior to the intro call should there be any concerns regarding a prior agreement to which you are a party or to any conflict of interest considerations. 

3. Confidential and Material Non-Public Information: You must not transmit information to MRM or its clients if you believe that to do so would result in a violation of any duty that you owe to a third party (including a breach of contract or of a confidentiality agreement), including anyone who is currently or has previously retained or employed you. You agree to not transmit information if you believe that someone breached a duty of confidence by disclosing the information to you. You agree to not transmit information where the source of the information believes that you agreed to hold such information in confidence. You shall not transmit to MRM or its clients any material, non-public information (or similar concept as defined under any applicable law or regulation) concerning any publicly traded company. By offering your knowledge to MRM or its clients, you represent that you have sufficient knowledge to make a reasonable determination of what constitutes material, non-public information, and that, when in doubt, you will refrain from passing along such information. 

4. Compliance with Law. In transmitting information to MRM or any of its clients, you agree to abide by all relevant laws, regulations and standards of care. In complying with relevant law, you understand that the information provided to MRM or its clients will be used for investment purposes. 

By responding to this email with your assent you are agreeing to each term and condition outlined in this agreement.

THE ABOVE TERMS AND CONDITIONS SHOULD BE CAREFULLY READ, UNDERSTOOD AND ACCEPTED BY CONSULTANT BEFORE PARTICIPATING IN CONSULTATIONS WITH MRM AND MRM CLIENTS. PLEASE CLICK BELOW TO SIGN THIS AGREEMENT AND THEREBY LEGALLY BIND YOURSELF TO THE TERMS AND CONDITIONS CONTAINED IN THIS AGREEMENT.  CLICKING BELOW IS THE EQUIVALENT OF CONSULTANT MANUALLY SIGNING THIS AGREEMENT.