Consultancy Application Form

Please complete the form below. Mandatory fields Marked *

 

Primary Client Details

Consultancy Products:*
Primary Client Name:*

Example: John Smith

CNIC No.*

Example: 1234567890123

Date of Birth:*

Example: MM/DD/YY

Gender:*
Marital Status:*
Mother Maiden Name:*

Example: Smith, Petter, etc.

Profession:*

Example: Teacher, Student, etc.

Residential Address:*

Example: House#, Block/Street, City/Town, Country.

Office Address:*

Example: Office#, Building/Floor, City/Town, Country.

Residence Phone:

Example: (Country Code) - (Area Code) - (Number)

Office Phone:*

Example: (Country Code) - (Area Code) - (Number)

Mobile:*

Example: (Country Code) - (Area Code) - (Number)

Email:*

Example: example555@example.com

Secondary Client (If Applicable)

Secondary Client Details (If Applicable)

Secondary Client Name:*

Example: John Smith

CNIC No.*

Example: 1234567890123

Date of Birth:*

Example: MM/DD/YY

Gender:*
Marital Status:*
Mother Maiden Name:*

Example: Smith, Petter, etc.

Profession:*

Example: Teacher, Student, etc.

Residential Address:*

Example: House#, Block/Street, City/Town, Country.

Office Address:*

Example: Office#, Building/Floor, City/Town, Country.

Residence Phone:

Example: (Country Code) - (Area Code) - (Number)

Office Phone:*

Example: (Country Code) - (Area Code) - (Number)

Mobile:*

Example: (Country Code) - (Area Code) - (Number)

Email:*

Example: example555@example.com

I hereby agree to the Terms and Conditions laid down in the Risk Disclosure Undertaking
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*The referring broker hereby has no liability of the amount invested by the client.
**Liability of the assigned referring broker will be limited to the capital protection defined by the client.This liability is limited for trading purpose only and not a liability on FXCM behalf.
***The referring broker hereby has no liability of the amount invested by the client and no expected return being issued.
* Without proper risk management, currency trading has a high degree of leverage which can lead to large losses as well as gains.
Shivani Financial Interest Free FOREX Trading