------- Floyd Upperman & Associates Membership Form ------
Fax (614-920-9749) or Phone (614-920-9746) Credit Card orders or;
Mail completed form along with certified check or money-order to:
                             
Floyd Upperman & Associates 
QUESTIONS?  CALL  614-920-9746 or email floyd@upperman.com

(Visa / MC /AMEX and Discover all Accepted)
   
 
Payment Choice:        Monthly  @ $89             Quarterly  @ $259   
                (
Membership dues)        [  ] Twice Yearly @ $495      [  ]  Yearly  @ $949 (Free Video)*

*
Yearly memberships receive 12 hour video free
To receive the 12-hr  workshop video at startup for $200 (50% off),  please check here  [   ]
You receive -> Access to the vault where Floyd's proprietary trading systems and data reside along with
 
our
on-line trading manuals and help section!   Each new member is licensed to access all proprietary 
graphs, charts and indicators for private trading.  You will also receive a hard-copy of the deluxe manual.

Membership is limited to private traders only   No Brokers, reg./unreg. CTA's, CPO's or fund managers.


Private Trader Agreement form for access to Floyd Upperman & Associates Trading System


Name:  _________________________________________________________________

Address:  _______________________________________________________________

City:  ______________________________________  St./Pr.:  ____    Zip: __________

Visa / MC     _____________________________________________________________

Exp. Date:  _____________________    Phone:  (_______) ______________________

Signature:  _____________________________________________________________

    (Signature required for credit card orders)

e-mail address : _________________________________________________________

By signing your name below you agree to abide by our rules and regulations.  Brokers, CPO's, CTA's, fund managers & institutional investors are strictly prohibited membership.  By signing below you agree to keep all the information pertaining to Floyd's trading system strictly confidential and for your own personal trading.  Membership is limited to individual traders and Floyd reserves the right to deny membership at any time for any reason.  Usernames and passwords are to be used by members only.  Unique IP addresses identify the computer you use to log onto our web site.  You need to inform Floyd Upperman & Associates if you plan on using more than one computer system.  Your signature below confirms that you are fully aware of the risks involved in futures trading. You agree that Floyd Upperman & Associates are not liable for any gain or loss to your account.  In addition, your signature below confirms you are not affiliated with any Futures Trading Firm. The one-time start up fee for complete access to Floyd's proprietary trading system is not refundable once a username and password are issued.  For your convenience, we will automatically bill your card for the requested membership plan upon the renewal date to ensure no interruption in service unless you request otherwise.  If for any reason you are dissatisfied,  let us know in the first 30 days and upon receipt of this signed form and our videos/manuals,  we will refund your membership dues (except when receiving the 12 hour workshop video for  free). Your signature below confirms you will maintain and protect the secrecy of the proprietary trading information. There is a $20 charge for shipping abroad.  Upon receipt of the completed form, your membership application will be processed within 24 hours!

Signature:  __________________________________________________________

We look forward to working with you!      Welcome aboard!      
Floyd W. Upperman Jr. CTA