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To sign up as an affiliate, please fill out the form below.
Personal Information
First name:
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Last name:
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Country:
Website:
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Email Address:
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Username:
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Payment information (you can fill it out later)
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Beneficiary details
Name:
Address:
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Bank details
Account No. / IBAN:
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SWIFT:
Intermediary bank:
Intermediary address:
Intermediary Routing/SWIFT:
PayPal details
PayPal account E-Mail:
Web Money details
Web Money Identification (WM-ID):
Please note that your payment could only be transferred via WMZ - currency equivalent to the USD.
Account information
Where did you find out about our program?:
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*Where do you plan to promote our products?

CPI Inquiry:

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