| I am... | a publisher an advertiser |
| Type of Account | |
Contact Information |
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| First Name | |
| Last Name | |
| Company Name (Checks Payable To) | |
| Street/Suite | |
| City | |
| State/Province | |
| Country | |
| Zip/Postal Code | |
| Work Phone Number (e.g. 5554614120) | |
| Cellphone Number | (optional) |
| Fax Number | |
| Email Address | |
| AIM Screen Name | (optional) |
| Preferred Method of Communication | |
Payment Information |
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| Checks Payable to | |
| Tax ID/SSN | |
Publishing Information |
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| Which type of traffic will you be generating? |
Email Search - PPC Search - SEO Display - Banners Display - Text Links Affiliate Network |
| Is your traffic incentivized? | No Yes |
| Website URL | |
| Description of Website | |
| What other Affiliate Networks do you currently work with? | (optional) |
| What types of campaigns currently work for you? | (optional) |
Login Information |
|
| Choose Your Username | |
| Password | |
| Re-type Password | |
| How did you hear about us? | |
Terms and Conditions |
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| I have read and agree to be bound by the AdDrive Terms and Conditions | |
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