Program Publisher Registration | The Affiliate Gateway

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Publisher/Company Name Should be 2 or more characters

Company Registration No.

Tax Residency

Title

Contact Name

Email (Username)

Confirm Email (Username)

Password Should be 8 or more characters. Must contain atleast one uppercase, one lowercase, one digit & one special character.

Confirm Password Should be 8 or more characters. Must contain atleast one uppercase, one lowercase, one digit & one special character.

Security Question

Security Answer

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Publisher Primary Market

Promotional Type

Website URL Must start with https:// or http://

Publisher Sectors

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United Kingdom VAT Registered

Yes

United Kingdom VAT Registered No. Can contain only alphanumeric, hyphen(-), dot(.) and space

Address Line 1

Address Line 2

City

Postcode Can contain only alphanumeric characters

Country

Telephone Should start with plus(+) sign, followed by numbers

Payment Currency

Bank Name

Bank Address

Account Name

Bank Sort Code Can contain only alphanumeric characters

Bank Account No Can contain only alphanumeric characters

SWIFT Code Can contain only alphanumeric characters

IBAN/BSB Number Can contain only alphanumeric characters

I accept the Terms & Conditions

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