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  First Name:
  Last Name:
  Email:
  City:
  State:
  Country:
  Phone:
  Best Time to Call:
  Describe Your Day Trading Style:
  Average Leverage Used:
  Average Round Trip Trades/Day:
  Average Time in a Trade:
  Longest Time in a Trade:
  Monthly Profit Objective (in %):
  Average Monthly Drawdown (%):
  Maximum Drawdown (%):
  Current Platforms Used to Trade:
  Do you know how to use MetaTrader 4?:
  Do you have a live track record?:
  Length of Track Record:
  Experience:
  Are you an introducing broker?:
  If yes; for wich firms?:
  Comments: