Tactical Range Request Form

This form is intended to collect the information necessary to create the legal documents required to subscribe to the Tactical Range signal. Please be advised that the United States CFTC considers FOREX signal and alert messages to constitute commodity trading advice. Accordingly the CFTC requires persons or organizations acting as Commodity Trading Advisors (CTA) to properly inform clients of the risks associated with trading FOREX. In compliance with CFTC regulations, Neuro Forex will use the information you supply on this form to create a risk advisory document. The document is in PDF format which we will email to the address you specify on this form. Please sign the document and fax it back to us. Alternatively, you may scan the signed document and email it as an attachment. Once we have received a signed risk advisory document we will provide you with a login which can be used to establish a monthly recurring subscription through Pay Pal. Your subscription will begin when the first month subscription fee is received. Of course, you may change your mind at any time during this process. We do not employ high pressure sales tactics and will not seek to contact you again once you have indicated that you do not wish to proceed. You may cancel your subscription at any time and we will issue a full refund of the current month. If you would like to speak with us directly please see our  contact  page for our hours of operation and telephone numbers. We will be happy to answer questions regarding any of our products.

Please note that we perform reverse lookups on telephone numbers and residential addresses and we do not respond to forms which appear to contain fraudulent information. Neuro Forex will contact you by email when we have processed your request so please be sure to add support@neuroforex.com to your email contact list. Otherwise, our response may end up in your bulk folder. If you have not received a response within 48 hours please call us directly on the support telephone number listed on the  contact  page.

Unique Experiences and past performances do not guarantee future results! Trading Stocks, Futures, Options and Spot Currencies involve substantial risk and there is always the potential for loss. Your trading results may vary. Because the risk factor is high trading the Foreign Exchange Market, only genuine "risk" capital should be used in such trading. If you do not have extra money that you can afford to lose then you should not trade in the Foreign Exchange Market (FOREX). No "safe" trading system has ever been devised and no one can guarantee profits or freedom from loss.

Subscription Information System: Tactical Range Eligibility: Two Years Live FOREX Trading Experience Cost: $300.00 (three hundred dollars) Monthly   Please Enter Your Contact Information Below: *First Name: *Last Name: Company (if applicable): *Mailing Address: *City: *State: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming *Country: Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Ascension Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory British Virgin Islands Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Islands Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Heard and McDonald Islands Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Ivory Coast Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea, North Korea, South Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia, Former Yugoslav Republic of Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia, Federated States of Moldova Monaco Mongolia Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Island Poland Portugal Puerto Rico Qatar Reunion Romania Russia Rwanda S. Georgia and S. Sandwich Islands. Saint Helena Saint Kitts And Nevis Saint Lucia Saint Pierre and Miquelon Saint Vincent and The Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Seychelles Sierra Leone Singapore Slovakia Slovenia Somalia South Africa Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Islands Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Minor Outlying Islands United States of America Unknown country Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam Virgin Islands Wallis and Futuna Islands Western Sahara Yemen Yugoslavia (Former) Zaire Zambia Zimbabwe *Zip Code: *Phone: Fax: *Email Address:   *Please Describe Your Experience Trading Commodities or Securities: (include number of years trading FOREX or currency futures)

Privacy Policy
The information collected on this form is never sold, distributed or shared with any other organization, person or entity. Your information is not stored on servers which are connected to the internet or any public exchange system. We value the privacy of all Neuro Forex customers and promise to safeguard this information to the fullest. Neuro Forex is a financial institution regulated by United States agencies and are required by law to collect information which can be used to verify identity, residence and certification. The information you provide here will be used to create legal documents required to subscribe to our forecast. If you choose not to subscribe, after receiving our risk advisory document, we will not contact you further including by email and you will not become part of any mailing lists.

U.S. Government Required Disclaimer
Commodity Futures Trading Commission (CFTC). FOREX, Futures and Options Trading have large potential rewards buy also large potential risk. You must be aware of the risks and be willing to accept them in order to invest in the FOREX, Futures and Options Markets. Don't trade with money you can't afford to lose. This web site is neither a solicitation for, nor an offer to Buy/Sell Futures or Options. No representation is being made that any account will or is likely to achieve profits or losses similar to those discussed on this web site. The past performance of any trading system or methodology is not necessarily indicative of future results.