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If you wish to register as an affiliate, please fill out the form provided for you below. The Payment Method drop-down menu lets you pick how you want to be paid for your traffic, and the Minimum Payout drop-down menu lets you pick the amount of payment you have to reach in order to be paid.

Your Company Information
*Site Name
*Site URL
 
Personal Information
*FIRST Name
*LAST Name
*Email
*Verify Email
 
ICQ Number
MSN
AIM
YAHOO IM
 
Account Information
*Username
*Password
*Verify Password
 
*Address Line 1
Address Line 2
*City
*State/Province
*Zip/Post Code
*Country
 
Payment Details
*Tax ID/SSN (US only)
*Pick Payment Type