Once you've filled everything out, tap continue (this may take a moment). You will also be asked to choose a password, pick and answer three security questions, and input an optional rescue email address. You'll be asked to enter in a birthdate, name, and email address (you'll need to enter in a different email address from your other iTunes/iCloud account). Either use an alternate email address, or have Apple create a new iCloud address for you. Go to Settings > iCloud and tap Create a new Apple ID. Once you're all signed out of your iTunes/iCloud account, you can create a new account. Your iPhone will also prompt you to choose whether to keep iCloud data and contacts on your iPhone, and then asks you to enter in your iCloud password to turn off Find My iPhone. Keep everything on your phone if you want to switch between accounts. Tap Sign Out to sign out of your iTunes/iCloud account - your iPhone will warn you that if you sign out of your account, all photo stream photos, documents, and data stored in iCloud will be removed from your iPhone. Scroll to the bottom of the screen, where you'll see a button that says Sign Out. Do this by opening Settings and tapping iCloud. To create a new iTunes account, you'll first need to sign out of your current iTunes/iCloud account. Or you can create a second Apple ID for a different country, and just sign in and out of the store.

You can change your country in the App Store, but going back and forth gets to be kind of a hassle, since you'll have to input new payment information each time. There are other-country-specific apps, as well as apps that are 'soft launching' in smaller markets - but what if you want to download those apps? In fact, not all apps are available to you in the US.

How to make a new itunes account