Extended Learning Track (XLT) Information Request

Contact Information

First Name:*

Last Name:*

Email:*

Phone:*

Mobile Phone:

Street Address:*

City:*

State:*

Zip Code:*

Country:*

Personal Background

I am most interested in mentoring in the following: (choose one)
Stocks Exchange Traded Funds (ETFs) Foreign Exchange (Forex) All of the above

Please note that all of the following fields are limited to 200 characters in each field. 

Background (Where are you from, Education Level, Occupation, Hobbies, etc):

What Areas do you wish to concentrate on?

What do you consider are your greatest Strengths?

What do you consider are your greatest Weaknesses?

Trading Background

Favorite Instrument (Stocks, Options, Forex, Futures, Bonds):

Trade Style (Scalp, Momentum, Swing, Position):

How long have you been trading?

Past/Current Broker

Average Number of Trades
Per Day  Per Month 

Electronic Platform Used

Level II Experience, if any

Trading Education (Classes, Seminars, Videos, CDs):

What are your Favorite TA Studies (RSI, MACD, Momentum, Stochastics, Bollinger Bands, Etc) and Please list your Expertise in Each:

Computer and Scheduling Details

Internet Connectivity (56K Dial Up, Cable Modem, ADSL/DSL):

Can you be online and use the phone at the same time?
YES NO

Requested Schedule (Example – 1 hr/day, Mon, Wed & Fri at 10am EST*):

(*Schedule will be set by Online Trading Academy – We will try to accommodate where possible) 

Any Special Considerations we should know about (Limited time, Daytime or Evenings only, Hearing problems, Medical needs, etc):