WealthTrade FX

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New Application Form

Start Trading Forex & CFDs

To get started, please fill in your details in the below application form.

If you have any trouble completing this form or require any assistance, please email us at Support@WealthTradeFX.com. We look forward to welcoming you as a WealthTrade FX trader.

*Mandatory fields

Primary Account Holder's Personal Details

First Name: *

Last Name: *

Email: *

Email Confirm: *

Gender: * Male Female

Marital Status: * Married Single

Number of Dependents: *

Date of Birth:*

Citizenship: *

Country of Residence: *

Primary Account Holder's Contact Information

Address 1: *

Address 2:

City: *

State/Providence: *

Zip/Postal code: *

Country: *

CountryAreaNumber

Phone 1*+

Phone 1 Country: *

-

Phone 1 Area: *

-

Phone 1 Number: *

Help- Country (1-3 digits)
- Area (1-4 digits)
- Number (5 – 12 digits, can contain # for extension)

Phone 2+

Phone 2 Country:

-

Phone 2 Area:

-

Phone 2 Number:

Primary Account Holder's Personal Identification Information

SSN or Government Issue ID: *

Drivers License, Passport, Voter Registration Number: *

Secondary Account Holder's Personal Details

First Name: *

Last Name: *

Email: *

Email Confirm: *

Gender: * Male Female

Marital Status: * Married Single

Number of Dependents: *

Date of Birth:*

Citizenship: *

Country of Residence: *

Secondary Account Holder's Contact Information

Address 1: *

Address 2:

City: *

State/Providence: *

Zip/Postal code: *

Country: *

CountryAreaNumber

Phone 1*+

Phone 1 Country: *

-

Phone 1 Area: *

-

Phone 1 Number: *

Help- Country (1-3 digits)
- Area (1-4 digits)
- Number (5 – 12 digits, can contain # for extension)

Phone 2+

Phone 2 Country:

-

Phone 2 Area:

-

Phone 2 Number:

Secondary Account Holder's Personal Identification Information

SSN or Government Issue ID: *

Drivers License, Passport, Voter Registration Number: *

Account Security

Security Question: *

Answer: *

Account Details

Choose Preferred Platform: *

Choose Account Type: *

Choose Currency Type: *

Password: *

Confirm Password: *

Registration Options

Language: *

Intended Investment: *

Leverage: *

Primary Account Holder's Financial Information

Estimated Gross Income: *

What is your estimated annual gross income?

Income Source: *

What is your main source of income?

Net Worth: *

What is your estimated net worth?

Liquid Assets: *

What is your liquid asset worth?

Bankruptcy Declaration: *

Have you ever declared bankruptcy within the past 10 years?

Secondary Account Holder's Financial Information

Estimated Gross Income: *

What is your estimated annual gross income?

Income Source: *

What is your main source of income?

Net Worth: *

What is your estimated net worth?

Liquid Assets: *

What is your liquid asset worth?

Bankruptcy Declaration: *

Have you ever declared bankruptcy within the past 10 years?

Combined Experience & Qualifications

Trading Experience: *

How many years of experience do you have trading forex, commodities and/ or CFD's?

Trading Frequency: *

In the past 12 months, how many times have you traded forex, commodities or CFD's?

Do you have any experience or qualifications that will help you in understanding our services? *

Occupational experience: I have a good understanding of leveraged derivatives through working in the financial sector.
Qualifications: I have a good understanding of leveraged derivatives because of a relevent professional qualification and/or education.
I have used the Demo platform to gain experience of trading WealthTrade FX products

Combined Relevance

* I consider WealthTrade FX's offered product(s) (as relevant) as being suitable products
Yes No
* Are you, or any person having interest in this account, a general partner, officer, director, owner of more than ten percent of the equity interest, associate person or employee of retail forex counterparty?
Yes No
* Are you, or any person having interest in this account, a relative of or do you share the same home with - a general partner, officer, director, owner of more than ten percent of the equity interest, associate person or employee of retail forex counterparty?
Yes No
* Are you or any person having interest in this account; 1) a member of any commodity exchange; 2) an Affiliated Person (AP) with any other CFTC, FSA or NFA registered firm; or 3) an employee of a regulatory agency?
Yes No

Customer Agreements

By clicking 'Yes' I herby acknowledge that I have received and understood the Risk Disclosure Statement and all of the following disclosures, statements, and terms.

Risk Disclosure Statement* Yes No

Notice to Traders and Referral Disclosure* Yes No

Trader Agreement and FX Agreement* Yes No

Lending Agreement* Yes No

High Risk Investment Notice* Yes No

Social Security or Tax ID Certification & Backup Withholding Statement* Yes No

Concent to Jurisdiction and Venue* Yes No

Authorization to Transfer Funds and Consent to Electronic Signature* Yes No

Concent to Electronic Transmission of Confirmations and Account Statements* Yes No

Arbitration Agreement* Yes No

No Dealing Desk Disclosure* Yes No

I understand that by clicking "I Agree" following this notice, I am providing written instructions to WealthTrade FX, Ltd under the Fair Credit Reporting Act authorizing WealthTrade FX, Ltd to obtain information from my personal credit profile or other information from Experian. I authorize WealthTrade FX, Ltd to obtain such information soley to confirm my identity and to avoid fraudulent transactions in my name.

I Agree

I herby represent that the information provided by me contained herein is true and correct. I further represent that I will notify WealthTrade FX, Ltd of any material changes in writing. WealthTrade FX, Ltd reserves the right, but has no duty, to verify the accuracy of information provided, and to contact such bankwewrs, brokers, and others as it deems necessary.

By submitting below, I acknowledge that this is a legally binding contractual agreement. I have read it carefully, and by submitting this agreement application, I agree to be bound by every term and condition, including the items listed above. No modification of this agreement is valid unless accepted by WealthTrade FX, Ltd in writing. I confirm that I have downloaded a full set of account documents from your website and I have not made any alterations od deletions to this agreement or any such documents from the original forms posted on the website. In the evnet that there are any alterations or deletions to this agreement or any such documents such alteration and deletions shall not be binding on you and said original forms shall govern Trader account relationship with WealthTrade FX, Ltd.

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