Business opportunities for publishers. Registration form.

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PUBLISHER APPLICATION FORM

Fill out this form to become a Cashfiesta Publisher.

All fields are required unless otherwise noted.
Please use only Latin characters!

Web Site Information

Your Web Site URL:

Does your site offer incentives to users?
Yes No

Contact Information

First Name:

Last Name:

Company Name:

If applicable

Title:

E-mail Address:

Valid Email REQUIRED for password retrieval.

Payment Information

Affiliate Program Type:

Checks Payable To:

Address:

City:

Zip Code:

State:

U.S. residents only.

Country:

Note for U.S. residents: In order to comply with IRS regulations, we'll request that you send us a Tax ID/SSN once your earnings exceed $500.

Account Information

Username:

Minimum 3 characters, not case-sensitive.

Password:

Minimum 4 characters, letters and numbers only. Password is case-sensitive.

Verify Password:

Cashfiesta Publisher Agreement

By submitting your registration information, you indicate that you agree with the Cashfiesta Publisher Agreement.