Affiliate Application

Primary Email: Please enter the email address that we should use for all correspondence regarding payments, news, and more. This will be the single email address associated with your account.

Primary Email:

Password:

Confirm Password:
Payee: Please enter contact information for the person or company to whom we should make checks payable.

Payee Name:


Enter the name exactly as it should appear on the check. If the check is to be mailed to an individual other than the Payee, enter "Attention:" and the name of the recipient in "Address 1" below.

Address Line 1:

Address Line 2:

Address Line 3:

City:

State, Province, or Region:

Zip or Postal Code:

Country:

Phone Number:
Payee Tax Information (for U.S. citizens, residents, and organizations): If you are an individual, please enter your U.S. Social Security number and your name; if you represent an organization, please enter its IRS employer identification number (EIN) and the organization's name.

Tax ID Number:

Tax Registration Name:

Tax Classification:
Contact: Please enter contact information for the person responsible for maintaining your Web site. For most Associates, the Payee and Contact are identical.
Check here if your Payee and Contact information are identical, and then skip to the next section.

Contact Name:

Address Line 1:

Address Line 2:

Address Line 3:

City:

State, Province, or Region:

Zip or Postal Code:

Country:

Phone Number
Describe Your Web Site

What is the name of your Web Site?

List your Web Site URL(s)

Please enter the URLs, one per line.

How did you learn about the Affiliate Program?

Description and Comments:

Briefly describe your site, including the type of items you intend to list. ( Please try to keep this under 10 lines or so)