www.highlandbrokerage.com Open in urlscan Pro
2620:1ec:46::45  Public Scan

Submitted URL: http://highland.com/
Effective URL: https://www.highlandbrokerage.com/
Submission: On January 05 via api from US — Scanned from DE

Form analysis 1 forms found in the DOM

POST https://dev.highlandbrokerage.com/api/v1/registration/postasync

<form action="https://dev.highlandbrokerage.com/api/v1/registration/postasync" method="post">
  <div>
    <div class="registration-input input-wrapper">
      <label for="FirstName">First Name</label>
      <input type="text" id="FirstName" name="FirstName" placeholder="First Name" required="">
    </div>
    <div class="registration-input input-wrapper">
      <label for="LastName">Last Name</label>
      <input type="text" id="LastName" name="LastName" placeholder="Last Name" required="">
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  </div>
  <div>
    <div class="registration-input input-wrapper">
      <label for="CompanyName">Company Name (optional)</label>
      <input type="text" id="CompanyName" name="CompanyName" placeholder="- - -">
    </div>
    <div class="registration-input input-wrapper">
      <label for="ZipCode">Zip Code</label>
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  </div>
  <div>
    <div class="registration-input input-wrapper">
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      <input type="email" id="Email" name="Email" placeholder="example@email.com" required="">
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    <div class="registration-input input-wrapper">
      <label for="PhoneNumber">Phone Number</label>
      <input type="tel" id="PhoneNumber" name="PhoneNumber" placeholder="(000) 000 - 0000" required="">
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    <div class="registration-input input-wrapper">
      <label for="Password">Password</label>
      <input type="password" id="password-field" name="Password" aria-describedby="passwordRequirements" required="" onblur="ValidatePassword(this.value)">
      <span toggle="#password-field" class="fa fa-fw fa-eye field-icon toggle-password"></span>
      <p id="lengthError" style="display:none">Password must be at least 8 characters in length</p>
      <p id="upperCaseError" style="display:none">Password is missing an uppercase character</p>
      <p id="lowerCaseError" style="display:none">Password is missing a lowercase character</p>
      <p id="numberError" style="display:none">Password is missing a number</p>
      <p id="symbolError" style="display:none">Password is missing a symbol</p>
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    <div class="registration-input input-wrapper password-reqs">
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        <li> Must be at least 8 characters in length, and include three of four of the following: <ul>
            <li>An uppercase character</li>
            <li>A lowercase character</li>
            <li>A number</li>
            <li>A symbol</li>
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        </li>
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  <div class="input-wrapper full-width-input">
    <fieldset>
      <legend class="sr-only">Are you currently working with Highland?</legend>
      <input id="WorkingWithHighland" type="checkbox" name="WorkingWithHighland" value="WorkingWithHighland">
      <label for="WorkingWithHighland">I'm currently working with Highland.</label><br>
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  <div class="registration-input input-wrapper jsHidden" style="display: none;">
    <label for="WhoWorkingWith">Who are you currently working with?</label>
    <input type="text" id="WhoWorkingWith" name="WhoWorkingWith">
  </div>
  <div class="full-width-input input-wrapper jsToHide">
    <label for="AboutUs">Tell us how you heard about us? (optional)</label>
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  </div>
  <div class="input-wrapper full-width-input">
    <fieldset>
      <legend class="sr-only">Are you a licensed Agent?</legend>
      <input id="LicencedAgent" type="checkbox" name="licencedagent" value="licenced" required="" onclick="ToggleSubmit()">
      <label for="LicencedAgent">I am a licensed agent and agree to the <a href="#">Terms and Conditions</a>.</label><br>
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  </div>
  <div>
    <button type="reset" class="secondary-button" value="Reset">Reset</button>
    <button id="submit" type="submit" class="button teal" disabled="" value="Submit">Submit</button>
  </div>
  <input type="hidden" value="test@highland.com" name="AdminEmail">
  <input type="hidden" value="4928e6e0-adf5-44a6-be51-0f04c1ea3a7f" name="Role">
</form>

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READY TO ELEVATE YOUR BUSINESS?

All financial services distribution companies are not created equal. Highland
Capital Brokerage offers an unparalleled national team dedicated to supporting
financial advisors who want to provide their clients with best-in-class life
insurance, annuities, longevity planning, and disability insurance.


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WE DO MORE:

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REGISTRATION FORM

First Name
Last Name
Company Name (optional)
Zip Code
Email
Phone Number
Password

Password must be at least 8 characters in length

Password is missing an uppercase character

Password is missing a lowercase character

Password is missing a number

Password is missing a symbol

 * Must be at least 8 characters in length, and include three of four of the
   following:
   * An uppercase character
   * A lowercase character
   * A number
   * A symbol

Are you currently working with Highland? I'm currently working with Highland.

Who are you currently working with?
Tell us how you heard about us? (optional)
Are you a licensed Agent? I am a licensed agent and agree to the Terms and
Conditions.

Reset Submit
Highland Capital Brokerage is a dynamic life insurance, annuity, longevity
planning, and disability insurance distribution company providing innovative
protection and income solutions to advisors. We listen. We educate. We support.
We do more. We elevate your business as your trusted, planning partner. Contact
us today.

Call us: (855) HCB-4YOU or (855) 422-4968

Meet Highland
 * HCB Home
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 * Product Offerings
 * Who We Serve

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 * Advanced Planning
 * EasyLife
 * Foreign National
 * Solutions Center
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