Affiliate Application

First Name

Last Name

Email Address

Login and primary communication.

Mobile Phone

Optional but useful for text alerts, onboarding, or payout notifications.

Mailing Address / City / State / ZIP

For physical mail, compliance, and tax records.

Business & Tax Details

Are you signing up as an Individual or a Business?

IndividualBusiness / LLC / Corporation

Legal Business Name (if applicable)

Preferred Payout Method

Direct Deposit (ACH)PayPalCheck by Mail