rabbit

Welcome to our affiliate program. Please complete the form below to signup.

Fields marked with * must be completed.

* Login username Please ensure your username contains only letters, numbers, hyphens (-), and underscores (_).

* Login password Please ensure password contains at least one lowercase letter, one digit, and one uppercase letter.

* Confirm password

* Email address

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* Country

* Currency Your currency cannot be changed once you've registered.

* Choose a channel Choose which channel you would like to subscribe to.

* First Name

* Last Name

* Phone Number

* Street Address

* City

* State

* Postcode

* Company Name

* Skype/AIM

* Website URL/s

* How will you market us?

Website
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Other

Specify if other is chosen.

* Tax Registration I am registered for tax

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* Terms & Conditions Please read the Terms & Conditions before agreeing.

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Bank Wire payment instructions

Please insert details

* Payee name

* IBAN

* Bank Name

SWIFT

Invoicing Options

* Automatically generate payment invoices?

Automatically generate an invoice for each payment

* Biller details Invoice header example: Affiliate Inc. 123 Example Street, Windsor, 13345. ABN: 123 456 789 0

Default tax details

* Tax name

* Tax rate A tax rate percentage between 0 and 100: %

Tax note The tax note will appear beside the tax amount on the generated invoice.