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Registration Form and Client Questionnaire

This form is secure secure registration form

  • Carefully review Disclaimer, and Disclosure Statement, and Terms of Use Agreement

  • Carefully review Consulting Agreement (You will receive a Consulting Agreement to sign after registration.)

  • Review the Client Advisory Rate Schedule. An investment adviser representative will contact you after registration regarding which level of advisory service that you prefer.

  • After profile evaluation and acceptance as a client, you will receive a Sample Trading Plan, a Consulting Agreement for your review and signature, and login information.

  • After profile evaluation, you will receive a daily e-mail (or fax) with recommendations and portfolio updates

This form is transmitted securely. If you prefer, you may download the paperwork by clicking here and fax the completed paperwork to (888) 770-3715.

First Name: *
Last Name : *
Organization:
Address Line 1: *
Address Line 2:
City: *
State: *
Zip Code: *
Phone Number : * ( ex: 714-555-1212 )
Fax Number :   ( ex:  714-555-1212 )
E-mail: *
Re-type E-mail: *
Create a username: * ( min. 6 characters )
Create a password: * ( min. 6 characters )
Re-type password: * ( min. 6 characters )
Relationship Background
Client Type: *
Client Profile
Occupation: *
Spouse's Occupation: *
Combined Annual Income for Client(s): *
Approximate Net Worth: *
( all tangible and liquid assets minus liabilities )
Approximate Liquid Assets in Non-Retirement Accounts: *
( investments, funds, and savings )
Institutional Investor Profile (Professionals Only)
Nature of Business:
Officer or Title:
( ex: principal, registered rep., vice-president )
Number of Clients :
Investment Objectives ( may check more than one )
Income
Growth
Tax Free Income
Capital Gains
Preservation of Capital
How Would You Rate Your Risk Tolerance?
Extremely Low - Conservative Investments only
Low - Fairly Conservative
Medium - Takes some risk with diversification
Aggressive - Tolerant to higher risk with risk capital
Please answer these seven simple questions about your life stage, attitude toward risk, and other factors ( all fields required )
1. I plan to start withdrawing money from my investments for major needs in:
*
2. When I begin withdrawing money, I plan to spend it in:
*
3. My knowledge of investments is:
*
4. When deciding how to invest my money, I am: *
Most concerned about the possibility of my investment losing value
Equally concerned about the possibility of my investment losing or gaining value
Most concerned about the possibility of my investment gaining value
5. Select the investments you currently own or have owned in the past (select all that apply): *
Money Market Funds / Cash Equivalents
Bonds / Bond Funds
Stocks / Stock Funds
International Securities / ETF Funds
Commodity Futures
6. Imagine that the stock market has dropped by 25% in value over the past three months.  A stock that you own has also dropped by 25% in value.  What would you do with your shares? *
7. Consider the annual returns of the five hypothetical investment plans below.  Based on the range of possible outcomes shown, which plan would be most acceptable to you or best suit your investment philosophy? *

Investment Plan

 Average
Annualized

Best Case Scenario

Worst Case Scenario

Plan A

7.2%

16.3%

-5.6%

Plan B

9.0%

25.0%

-12.1%

Plan C

10.4%

33.6%

-18.2%

Plan D

11.7%

42.8%

-24.0%

Plan E

12.5%

50.0%

-28.2%
   
Billing Information
All billing is paid monthly and in advance.  All payments are made by credit card unless otherwise approved by Advisor.
Credit Card Type: *
Credit Card Number: *
Credit Card Expiration Date  *  *
  View Legal Disclaimer, Disclosure Statement and Terms Of Use Agreement
  I have reviewed the Disclaimer, Disclosure Statement, and the Website's Terms of Use in its entirety. I accept and agree to the Disclaimer, Disclosure Statement, and the Website's Terms of Use Agreement’s terms and conditions. *

RadRoch, Inc. will review your registration information and you will receive a response within 2 business days.  You will receive either an e-mail or telephone call from a RadRoch Investment Adviser regarding your profile evaluation and a sample Trading Plan. The investment adviser may also contact you for clarification or further questions. (Please note: RadRoch’s services are not suitable for all investors. Some applicants may not be accepted as clients. Please see the Disclaimer/Disclosure section.)

If you have any questions or concerns, please contact us at one of the following:

e-mail:  questions@radroch.com

Telephone:   1-888-770-3710

Mailing Address:
RadRoch, Inc.
Att: Customer Service
10120 Adams Avenue #200
Huntington Beach, CA 92646

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U.S. GOVERNMENT REQUIRED DISCLAIMER - COMMODITY FUTURES TRADING COMMISSION. FUTURES AND OPTIONS TRADING HAS LARGE POTENTIAL REWARDS, BUT ALSO LARGE POTENTIAL RISK. YOU MUST BE AWARE OF THE RISKS AND BE WILLING TO ACCEPT THEM IN ORDER TO INVEST IN THE FUTURES AND OPTIONS MARKETS. DO NOT TRADE WITH MONEY YOU CANNOT AFFORD TO LOSE. THIS WEBSITE IS NEITHER A SOLICITATION NOR AN OFFER TO BUY OR 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 WEBSITE. THE PAST PERFORMANCE OF ANY TRADING SYSTEM OR METHODOLOGY IS NOT NECESSARILY INDICATIVE OF FUTURE RESULTS.
CFTC RULE 4.41 - HYPOTHETICAL OR SIMULATED PERFORMANCE RESULTS HAVE CERTAIN LIMITATIONS. UNLIKE AN ACTUAL PERFORMANCE RECORD, SIMULATED RESULTS DO NOT REPRESENT ACTUAL TRADING. ALSO, SINCE THE TRADES HAVE NOT BEEN EXECUTED, THE RESULTS MAY HAVE UNDER-OR-OVER COMPENSATED FOR THE IMPACT, IF ANY, OF CERTAIN MARKET FACTORS, SUCH AS LACK OF LIQUIDITY. SIMULATED TRADING PROGRAMS IN GENERAL ARE ALSO SUBJECT TO THE FACT THAT THEY ARE DESIGNED WITH THE BENEFIT OF HINDSIGHT. NO REPRESENTATION IS BEING MADE THAT ANY ACCOUNT WILL OR IS LIKELY TO ACHIEVE PROFIT OR LOSSES SIMILAR TO THOSE SHOWN.
 

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