Signup

If you wish to register as an affiliate, please fill out form provided for you below. The Payment Method drop-down menu lets you pick how you want to be paid for your traffic, and the Minimum Payout drop-down menu lets you pick the amount of payment you have to reach in order to be paid.

12clickscash Affiliate Signup

Account Information
Username: Company:
Password: Verify Password:
URL:  
Preferences
Accept Mailings: Default Program:
Contact Information
E-mail: Verify E-mail:
ICQ: AIM:
Mailing Address
First Name: Last Name:
Address: Address (cont):
City: State:
Zip Code: Country:
Payment Details
Payment Method: Minimum Payout:
Pay To: Address:
Address (cont): City:
State: Zip Code:
Country:  
Tax ID/SSN: Only if in US  
SI Penn LLC - 67 Buck Rd STE 16 Huntingdon Valley PA 19006