Sample Affiliate Signup Form for LinkTrust Version 6.0 (View Source for HTML Code)

1. *Partner ID
2. *Password
3. *Company
4. *First Name
5. *Last Name
6. *Address1
7. Address2
8. *City
9. Province
10. *Country Code United States
11. *Postal Code
12. *Phone
13. Fax
14. *Business Type ID Email Banners Print Network Search Co-Reg Other
15. *Send Payments to Company Contact
16. *Business Description
17. *Tax ID or SSN
18. *Email Address
19. State Utah
20. *Company Website URL
21. *Payment Type Check PayPal Direct Deposit Wire
    1. If Direct Deposit:
       1. *Routing Number
          OR
       2. *Swift Code
    2. If Direct Deposit or Wire:
       1. *Bank Name
       2. *Bank Address
       3. *Account Name
       4. *Account Number
    3. If PayPal:
       1. *Paypal Email
22. IM Network ID AIM Google MSN Skype Yahoo
23. IM Address
24. Source
25. *Success URL
26. *Failure URL