Affiliate Application

For more information on how to sign up as an affiliate, please complete the form below or contact us.


Affiliate Sign Up

Required fields marked with an asterisk*
 
*First Name:
*Last Name:
*Choose a Password:
Company:
*Checks Payable To:
*Payment Threshold: £
*Email:
*Phone:
*Address:
Address2:
*City:
*County:
*Country:
*Postcode:
AIM:
 Site URL:
Site2 URL:
Site3 URL:
Site4 URL:
Site Categories:

Unique Visitors per Month:
*How will you promote our campaigns?
Do You Publish a Newsletter? No   Yes
(If Yes, Answer the Following:)
Number of Subscribers:
Do you send Solo email? No   Yes
Single or Double Optin? Single   Double
Mailing Frequency:
Do you record Time/Date/IP Stamp? No   Yes
*I have read and agree to the Primary Ads Affiliate Agreement.