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Affiliate Registration

This form is used to register as an affiliate and collect referral fees - it's FREE!.


Note: your information will be kept strictly confidential:

Note:


Affiliate Registration (* fields are required)
Name:
*
Address: *
City: *
State or Province:
Zip/Postal Code: *
Country Code (aa): *
Email:
Telephone:

The remaining field is not required to register as an affiliate, but is required
by the Internal Revenue Service before referral fees in excess of $400
can be disbursed (you will be issued Tax Form 1099 when earnings exceed
$400 per year). If you do not have a Social Security Number, you must
get an Individual Tax Identification Number.
Social Security Number
Individual Tax Id Number


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