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Check, Contact Name
& Mailing Address
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Important: The Checks
Payable To and the Address information below will be used to create and
mail checks for any fees that you earn. Please make sure all information is correct.
All monies are paid in U.S. Dollars.
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* Full Name |
First MI
Last
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Company |
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* Checks Payable To |
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* Address 1 |
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Address 2 |
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* City |
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* State |
* Postal
or Zip
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Province |
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* Country |
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* Phone |
Fax
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* E-mail |
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Enter a username and
password to access to your affiliate account
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* Your User Name |
(choose any name you prefer)
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* Your Password |
(5 to 12 chars - case sensitive) |
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* Confirm Password |
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Enter Your Site Information
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Site Name |
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Site URL |
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Required if you use AdminiTrack
content on a Web site
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Important Business
Information
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* Your tax classification
is
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* Social Security
Number or Federal Tax ID
(If you are an individual use your SSN.
If you are a corporation use your Federal Tax ID)
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* US residents must provide
a Social Security or Federal Tax ID Number in order to get paid. Registrees from
other countries are not required to complete this field. |
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I've read and agree to the affiliate Program Agreement |
Contact us at affiliates@AdminiTrack.com
if you have any questions.
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