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<html>

  <head>
    <meta http-equiv="Content-Type" content="text/html; charset=UTF-8" />
    <title>Your Website</title>
  </head>

  <body>
    <div class="mini-application">
      <div class="mini-application__header">
        <h1 class="mini-application__title--primary">
          Open a TradeStation Crypto Account
        </h1>
        <h2 class="mini-application__title--secondary">
          Step up to Cryptocurrencies trading
        </h2>
        <p class="mini-application__text">
          Cryptocurrencies trading is only offered by TradeStation Crypto, Inc., which is 
          a wholly owned subsidiary of TradeStation Group, Inc., operating, and providing 
          products and services, under the TradeStation brand and trademark.
        </p>
        <p class="mini-application__text">
          <strong>Important: </strong> Cryptocurrencies are traded through a new online platform. 
          You will need an Equities account in order to make easy money transfers to, and from, 
          your new TradeStation Crypto account. Please <a href="" target="_blank"> click here </a>
          for further information.
        </p>
        <p class="mini-application__text">
          Please complete the information requested below to open a Crypto account:
        </p>
      </div>
      
      <div class="mini-application__body">
        <form class="mini-application__form">
          <fieldset class="mini-application__section">
            <div class="mini-application__field">
              <label class="mini-application__label">Select Equities Account: </label>
              <input class="mini-application__input" type="text" value="small" />
            </div>
            <div class="mini-application__field">
              <label class="mini-application__label">First Name: </label>
              <input class="mini-application__input" type="text" value="small" />
            </div>
            <div class="mini-application__field">
              <label class="mini-application__label">Middle Initial: </label>
              <input class="mini-application__input" type="text" value="small" />
            </div>
            <div class="mini-application__field">
              <label class="mini-application__label">Last Name: </label>
              <input class="mini-application__input" type="text" value="small" />
            </div>
          </fieldset>
          <fieldset class="mini-application__section">
            <legend class="mini-application__title--tertiary">Residential Address</legend>
            <div class="mini-application__field">
              <label class="mini-application__label">Street Address Line 1: </label>
              <input class="mini-application__input" type="text" value="small" readonly />
            </div>
            <div class="mini-application__field">
              <label class="mini-application__label">Street Address Line 2: </label>
              <input class="mini-application__input" type="text" value="small" />
            </div>
            <div class="mini-application__field">
              <label class="mini-application__label">Street Address Line 3: </label>
              <input class="mini-application__input" type="text" value="small" />
            </div>
            <div class="mini-application__field">
              <label class="mini-application__label">City: </label>
              <input class="mini-application__input" type="text" value="small" />
            </div>
            <div class="mini-application__field">
              <label class="mini-application__label">Country: </label>
              <select class="mini-application__select">
                <option value="United States">United States</option>
              </select>
            </div>
            <div class="mini-application__field">
              <label class="mini-application__label">State/Province: </label>
              <select class="mini-application__select">
                <option value="Florida">Florida</option>
              </select>
            </div>
          </fieldset>
          <fieldset class="mini-application__section">
            <legend class="mini-application__title--tertiary">Identity Information</legend>
            <div class="mini-application__field">
              <label class="mini-application__label">Social Security#/Tax ID: </label>
              <input class="mini-application__input" type="text" value="small" />
            </div>
            <div class="mini-application__field">
              <label class="mini-application__label">Type of ID: </label>
              <input class="mini-application__input" type="text" value="small" />
            </div>
            <div class="mini-application__field">
              <label class="mini-application__label">ID Number: </label>
              <input class="mini-application__input" type="number" />
            </div>
            <div class="mini-application__field">
              <label class="mini-application__label">Expiration Date: </label>
              <input class="mini-application__datepicker" type="date" value="small" />
            </div>
          </fieldset>
        </form>
      </div>

      <div class="mini-application__footer">
        <div class="mini-application__text">
          By continuing, you consent to the collection, use, and transfer of your personal data 
          for processing as described in the <a href="" target="_blank"> Privacy Notice </a> and 
          <a href="" target="_blank"> Cookies Policy. </a>
        </div>
        <button class="mini-application__button--primary">Open Account</button>
      </div>
    </div>
  </body>

</html>