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Partners Form

For additional information on Introducing arrangements please complete the form:

* Indicates required field

Name *

First

Last

Email *

Phone Number *

Name of business *

Url, website address *

Years in business *

Are you registered entity in USA? *

Are you currently an IB with any other broker or FCM? *

Have any formal complaints? *

Briefly describe your business (i.e. Introducing broker, Introducing Agent; money manager, advisory service, white Label etc.) *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Number of Existing Customer Accounts *

Amount of customer margin (USD) *

What country or region will you be targeting? *

Are you registered entity outside of USA? *

Nominal Value (in your customers currency) *

Estimated lots per month? *

What are the major instruments to be traded? *

Please provide any additional information that you deem relevant *

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