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No free domains allowed. You need to own a support.com email address to be able to become our affiliate.

1. Account Information
Desired login name:*
Password:*
Retype password:*

Referred by:*

2. Personal
Full name:*

Email address:*
Confirm email:*

3. Business Information
Company:*

Zip:*
Country:*
State*	for US residents only
City:*
Street address:*
Phone #:*

Preferred payout option:*

4. Website and Members
Website URL:*
Monthly visitors:*	Approximate number of monthly visitors
Number of members:*	Overall number of members
Registered in the past 3 months:*

5. Member Payments Preferences
Member payments:	Please state the percent you want to pay your members for the following single offer payouts: payout less than $0.30: % (recommended 95%) $0.30 - $1.00 offers: $ % (recommended 90%) more than $1.00 offers: $ % (recommended 80%)

Fine amount:*	USD Please state the amount you want to fine your members by for every false completion of an offer. Required minimum is $0.50.