Application form

Country

City

Customer database (number of active traders)

Have you ever worked as a representative or a partner of other brokers? If you have, then specify the names of the companies.

Period of working as a representative or a partner

Availability of office rooms:

yes      no

Are you going to arrange training courses?

yes      no

Additional information

Contact person ’s full name

E-mail address

Affiliate’s code (ID)

Phone number