CHOOSE A BROKER
	Broker Name	:	FOREX.com (Minimum Deposit $250, Micro Account 0.01 lot) TradeViewForex.com (Minimum Deposit $100, Micro Account 0.01 lot) FXCM.co.uk (Minimum Deposit $300, Mini Account 0.1 lot) FXDD.com (Minimum Deposit $250, Micro Account 0.01 lot) ALPARI.co.uk (Minimum Deposit $200, Micro Account 0.01 lot) WSSFX Affiliate Network
	PRIVATE INFO
	Full Name*	:
	Email Address*	:
	Temporary Password*	:
	Full Address*	:
	City*	:
	State/Provice*	:
	Postal Code*	:
	Country*	:	Select Your Country Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaidjan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia-Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland Former Czechoslovakia Former USSR France France (European Territory) French Guyana French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Great Britain Greece Greenland Grenada Guadeloupe (French) Guam (USA) Guatemala Guinea Guinea Bissau Guyana Haiti Heard and McDonald Islands Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique (French) Mauritania Mauritius Mayotte Mexico Micronesia Moldavia Monaco Mongolia Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles Neutral Zone New Caledonia (French) New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea Northern Mariana Islands Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Island Poland Polynesia (French) Portugal Puerto Rico Qatar Reunion (French) Romania Russian Federation Rwanda S. Georgia and S. Saint Helena Saint Kitts and Nevis Saint Lucia Saint Pierre and Miquelon Saint Tome (Sao Tome) Saint Vincent and Grenadines Samoa San Marino Saudi Arabia Senegal Seychelles Sierra Leone Singapore Slovak Republic Slovenia Solomon Islands Somalia South Africa South Korea Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syria Tadjikistan Taiwan Tanzania Thailand Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu USA Minor Outlying Islands Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay Uzbekistan Vanuatu Vatican City State Venezuela Vietnam Virgin Islands (British) Virgin Islands (USA) Wallis and Futuna Islands Western Sahara Yemen Yugoslavia Zaire Zambia Zimbabwe
	Phone Number*	:
	SSN/TAX/Passport/KTP/ID Number*	:
	Website/Blog/Wordpress (if any)	:
	DOCUMENT
	Government ID/Driver License/Passport*	:	(JPG/GIF ONLY, LESS THAN 10MB)
	Utility Bill (Water/ Electricity/ Phone/ Credit card Statement)*	:	(JPG/GIF ONLY, LESS THAN 10MB)
Note : All document must have same name and address! (required for all brokers)
	EMPLOYMENT STATUS
	Employer's/Company Name*	:
	Years there*	:	0 year 1 year 2 years 3 years 4 years 5 years 6 years 7 years 8 years 9 years 10 years Over 10 years
	Employer's Address*	:
	Employer's City*	:
	Employer's State/Province*	:
	Employer's Postal Code*	:
	Business Telephone*	:
	Business Fax (if any)	:
	Business Email	:
	Type of Business*	:
	Position held*	:
Note : Please complete your employment status! (required for all brokers)
	BANK ACCOUNT INFO
	Bank Name*	:
	Bank Account Number*	:
	Bank Address*	:
	Bank City*	:
	Bank State/Province*	:
	Bank Postal Code*	:
	Bank ABA/SWIFTCODE*	:	(ask your bank if you dont know)
	ACCOUNT OPTIONS :
	Tipe Account	:	Micro Account Mini Account Regular Account
	Leverage	:	1:100 1:200 1:400 (TradeviewFX, FXCM) 1:500 (Alpari UK)
	Moslem Account (Free Swap/No Interest)	:	Yes No
	Deposit Plan (min $250)	:
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Financial Services Authority (FSA), United Kingdom	National Futures Association (NFA), United States	Malta Financial Services Authority (MFSA), Malta	Federal Financial Markets Service (FFMS), Russia

”Before deciding to participate in the Forex market, you should carefully consider your investment objectives, level of experience and risk appetite. Most importantly, do not invest money you cannot afford to lose. There is considerable exposure to risk in any off-exchange foreign exchange transaction, including, but not limited to, leverage, creditworthiness, limited regulatory protection and market volatility that may substantially affect the price, or liquidity of a currency or currency pair.

More over, the leveraged nature of forex trading means that any market movement will have an equally proportional effect on your deposited funds. This may work against you as well as for you. The possibility exists that you could sustain a total loss of initial margin funds and be required to deposit additional funds to maintain your position. If you fail to meet any margin requirement, your position may be liquidated and you will be responsible for any resulting losses. To manage exposure, employ risk-reducing strategies such as 'stop-loss' or 'limit' orders.”

One of the limitations of hypothetical performance results is that they are generally prepared with the benefit of hindsight.  In addition, hypothetical trading does not involve financial risk. Variables such as the ability to adhere to a particular trading program in spite of trading losses as well as maintaining adequate liquidity are material points which can adversely affect actual real trading results.”