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Name
*
First
Last
Email
*
Phone
*
Choice Of Trader
Trader 1 or Trader 2
Deposit Account Balance (copy)
Trading Type
Forex Bot/ Binary Bot/ Manual Fund Management
BROKER NAME
E.G DERIV, FXTM
BROKER SERVER
E.G DERIV LIVE,
MT4/MT5 LIVE ACCOUNT LOGIN
MT4/MT5 LIVE ACCOUNT PASSWORD
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