This Registration Form & Password Application are part of the Access Agreement as Annex A. Please fill out and submit the form below and you will be contacted by a True Quote representative.

* Required Fields

* Title: 

* First Name: 

* Last Name: 

* Company: 

* Job Title: 

* Department: 

* Address: 

* City: 

* State or Province: 

* Country: 

* Postal Code: 

* Company Phone: 

* Company Fax: 

* E-mail: 



What type of company and your role in that company? (select all that apply)

Broker
Marketer
Financial Institution
Distributor
Agriculture
Trader

Legal/Consulting
Utility
Trading Company
Energy
Insurance/Reinsurance
Producer

Internet/News
Industrial
Consulting
Media/Publisher
Investor


* I am interested in True Quote for: 

I heard of True Quote through: 


Password Application

Based upon the information provided by the Subscriber in this Registration Form, True Quote shall issue to the Subscriber a user id and password that will enable the Subscriber to access the Website. In addition to, and not in limitation of, its other obligations under the Access Agreement signed by it, the Subscriber agrees as follows:

(1) True Quote shall have no responsibility or liability for controlling, monitoring or using any user id or password. If the Subscriber creates any additional user id's or passwords, the Subscriber shall be solely responsible for the creation, monitoring and use of such user id's and passwords. The Subscriber shall also be solely responsible for the monitoring and use of any user id or password issued to the Subscriber by True Quote.

(2) Subscriber shall implement and enforce reasonable measures to protect the confidentiality of any and all user id's and passwords and shall immediately notify True Quote of any unauthorized disclosure or use of any user id's or passwords. The Subscriber shall provide a user id and password only to its employees who are authorized by the Subscriber to access the Website and execute Transactions on or view the Website.

(3) The Subscriber shall be solely responsible and liable for any Transaction executed on, or use of the Website by, any person using a user id or password created by or issued to the Subscriber.


* Initial Password:  (must be 8-32 characters)


For more information contact a True Quote representative at: 800.327.1499