Affiliate Sign-up Form

Personal Information

Fill out your personal information (fields in bold are required). Why do you need this information?


Choose a password that will allow you to login to your admin area.


Enter the domains where you will be linking marketing material from. You can enter either:

  • an exact path (
  • a sub-directory (
  • or a full domain (
Site Categories

Please choose up to three categories that describe your website or websites:

Site Information
Do You Publish a Newsletter?
Do you send Solo email?
Single or Double Optin?
Do you record Time/Date/IP Stamp?
Refer a Friend

Enter the email addresses of your friends to let them know about this affiliate program. If they follow the email link here and sign up, they will automatically become part of your second tier! (optional)