Introducing Broker Questionnaire
 

General Information
   
Full Name:
Company Name:
Phone:
Email:
Website:
Country:
Address:
How did you hear about us?
Broker
Website
Other. Please specify
   
Are you regulated? Yes  No
If yes, please name the regulatory body?
List Two Business References (Name, Address & Phone Number):
   
Business Information
   
Do you, currently, have clients that are ready to invest? Yes  No
If yes, how soon will these clients be ready to invest?
Are/Were you an Introducing Broker or Affiliate for other Money Manager(s)? Yes  No
If yes, please name the Money Manager(s) ?
What is the total amount you have referred to the other Money Manager(s)?
Do you have current relationships with Forex Dealers/ Brokers/FCMs? Yes  No
If yes, which FCMs:
What is the nature of your primary business?  
Trading proprietary accounts
 Managing accounts
Raising money
 Attracting clients for self-trading
 Training and education
 Other. Please explain:
 		 
   
Marketing Information
   
Please list all the geographic regions you are targeting or planning to target:
Briefly describe how you generate or solicit new clients:
Please specify the URL(s) of the Website(s) that the Company owns and intends to use to solicit clients for ICA :
What types of clients is the Company planning to target?  
Individual/Retail clients
 High net worth individuals
 Retired individuals
 Fund managers, investment funds
 Corporations/Institutional
 Other. Please explain:
 		 
   
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