Affiliate Registration
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Genius 2000 Affiliate Registration

Please complete as many of the fields on this form as you are able to. The fields marked with a * are mandatory. Please note that we will not be able to send your payments until you supply a postal address.

After you have signed up we will allocate a unique affiliate ID to you and provide details of special links for use on your site.

Company Name:

*

This is the name we will use for payment. If you are an individual please enter the name you would like on your payments here.
Contact Name:

*

 

This is the contact name we will use for post, emails and telephone contact.
Address:  
Postal/Zip Code:  
Country:  
Telephone:  
Fax:  
Email:

*

 

 
Website Address:

*

 

This should be the address of the website page where you intend to display the links. Do not include the http:// part.
User Name:

*

Please choose a memorable user name. You will use this and your password to log in to the members only area of the affiliate site. The user name must be 4 or more characters long with no spaces.
Password:

*

 

Choose a password you will use to access the members area. The password should be at least 6 characters long. Please remember this so you can log in to view your statistics.
Confirm Password:

*

 

Please retype the password above in this box.

Please note: In order to sign up to the Genius 2000 Affiliate Scheme you must agree to the Terms and Conditions. To view these Terms and Conditions please click here. You must tick the box below to continue.

I have read and agree to the Genius 2000 Affiliate Scheme Terms and Conditions.

 
 

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