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.

IndieBucks 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:
Bank Name:		Bank Address:
Bank City:		Bank State:
Bank Country:		SWIFTCODE:
Routing Number US:		Beneficiary Name:
Beneficiary Address:		Beneficiary City:
Beneficiary State:		Beneficiary Country:
Account Number:		IBAN:
Memo to Bank:		Extra Info: