Account Application

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Title *

First Name

Last Name

Email *

Phone *

Date of Birth *//

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Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

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Employment Status *

Occupation

Approx Annual Income *

Approx Monthly Expenses *

Approx Total Savings & Investments *

Source of Funds *

Any health conditions that would impact trading decisions? *

Your Overall Risk Profile *

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How many years experience do you have in Shares and ETFs *

How often have you traded Shares and ETFs *

How many years experience do you have in leveraged products (CFDs, Spreads, FX) *

How often have you traded leveraged products *

Do you have any experience working in the financial industry? *

What is your proposed funding amount? *

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Many thanks for your interest, but on the basis of your responses we are not able to offer you a CFD Account at this time.

Declaration *

Affirm

I confirm and agree that the information supplied on this questionnaire is true and correct. I have read Atlantic Capital Markets Ltd risk warning and understand the risks of CFD trading. Further, I undertake to notify Atlantic Capital Markets Ltd if there is any significant change to my personal or financial circumstances.

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Email *

Trading 01872 229 000 Enquiries 01209 316 171

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