FREE Currenex Bridge Questionnaire

Company Name *
Business Contact Info * First Last
Phone *
Email *
Address
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Technical Contact Info First Last
Phone - (###) - ### ####
Email
Are you FI (Financial Institution)? * Yes No
Are you an established Brokerage? * Yes No
If not, would you like to become one in the future? Yes No
What products do your clients require? * FX CFDs Futures Metals Commodities Indexes Others
If you check "Others" above, please list:

If you have other products, please list them
Do you have your own MT4 Server? * Yes No
What platform do you offer? * MT4 Currenex Others
Others:

Please list what platform you offer.
Do you have Prime Broker? * Yes No