-Secure Registration Form-

* Required Fields

Hidden Fields - HIDDEN

Initial Contact Method {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Form ID {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

DateTime Submitted {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Visitor ID {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Visitor ID reg {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

OtherParameters {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Ad URL Query {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

User Agent {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

IP Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Mobile Device? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Submissions start here

Data Security

We take the security of your information very seriously.

All the data and documents are encrypted before being sent over a secure (SSL) connection to a unique URL on our secure and encrypted servers. Venstar Exchange adheres to strict data protection protocols that keep more sensitive information, including all of the files you provide, in secure and encrypted ‘lock boxes’. Only authorized personnel with authenticated decryption keys can access these documents.

Minimum Amounts

If you expect to transact less than 5,000 USD equivalent per transaction then we suggest you first contact us so that we may determine if we are the best fit for your exchange requirements.

Your Details

Name Combined - HIDDEN {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

First Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Middle Names {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Last Name (Family Name) {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Email Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Phone

Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{ binding displayValue, mode=oneTime }

Country Code {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Area Code {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Number {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Services You Require

I wish to register as a(n): {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{ binding displayValue, mode=oneTime }

Redirect - HIDDEN {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

My Source Funds (the money I wish to exchange) will come from a Bank Account in my name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{ binding displayValue, mode=oneTime }

The funds to be exchanged will come from a bank account bearing the same name as the organization I am registering {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{ binding displayValue, mode=oneTime }

Expected Date of Next Transaction {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

(Format: M / D / YYYY)

Avg. Value per Trans. (not total) {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

e.g. 15,000 per transaction (estimates are fine)

Reason(s) for Exchange (see following examples) {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Reason for Exchange examples. Some detail is required.
- Paying tuition fees in Scotland
- Payments for machine parts in CAD
- Real estate mortgage payments
- Living expenses while located abroad
- Transfer of savings to bank account in my name
- Personal loan to family member to purchase car

Reason for Exchange examples. Some detail is required.
- Paying consulting fees in Scotland
- Payments for machine parts in CAD
- Paying wages in Germany
- Purchasing stock (wine) from suppliers in Italy

Click Next Page to continue

Save incomplete forms for up to 14 days.

After clicking SAVE you can either bookmark the updated URL or have it emailed to you.

-Secure Registration Form-

The email has been sent.

Your progress has been saved.

Copy your form link:

Email me my link:

{ binding firstError.message }

-Secure Registration Form-

* Required Fields

Hidden Fields - HIDDEN

Initial Contact Method {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Form ID {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

DateTime Submitted {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Visitor ID {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Visitor ID reg {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

OtherParameters {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Ad URL Query {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

User Agent {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

IP Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Mobile Device? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Submissions start here

Data Security

We take the security of your information very seriously.

Minimum Amounts

If you expect to transact less than 5,000 USD equivalent per transaction then we suggest you first contact us so that we may determine if we are the best fit for your exchange requirements.

Your Details

Name Combined - HIDDEN {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

First Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Middle Names {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Last Name (Family Name) {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Email Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Phone

Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Area Code {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Number {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Services You Require

I wish to register as a(n): {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Redirect - HIDDEN {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

My Source Funds (the money I wish to exchange) will come from a Bank Account in my name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

The funds to be exchanged will come from a bank account bearing the same name as the organization I am registering {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Expected Date of Next Transaction {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Avg. Value per Trans. (not total) {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Reason(s) for Exchange (see following examples) {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Click Next Page to continue

Save incomplete forms for up to 14 days.

After clicking SAVE you can either bookmark the updated URL or have it emailed to you.