| Brief
Description of Website |
|
| Website Stats |
* |
| |
Does
your Website...
Require a login?
Offer rewards/compensation?
Donate a portion of proceeds to an organization?
|
| |
Do you
manage more than one Website?
|
 |
|
|
--- Contact Information --- |
| First
Name |
*
|
| Last
Name |
* |
| Email
Address |
*
*
Your email address must be valid. Upon completion of your registration,
you will receive an email with your Username and Password so you can login
to your new affiliate account. If you do not login to your new account
within 10 days of your registration, you will not receive future emails
and your account may be terminated. Please type email address twice to
confirm. |
| Phone
Number |
*
Use numbers only - no dashes, parentheses, etc. |
| Mailing Address |
*
|
| City
|
* |
| State
or Province |
*
If Other, please specify |
| Zip
or Postal Code |
* |
| Country |
* |
|
|
|
--- Payment Information --- |
| |
IMPORTANT: Please read the information in this section carefully
and ensure that the information you enter is correct. Failure to do so
may unnecessarily delay commission payments to you. |
| Make
Checks Payable To: |
* |
| |
Taxpayer
Identification Numbers (TIN) for U.S. persons and firms to whom Lamas,
Inc. will make disbursements. The number you provide MUST correspond to
the payee you have identified above. For individuals, this number is your
Social Security Number (SSN). For other entities, it is your Employer
Identification Number (EIN). |
| Taxpayer Identification Number |
*
Required of all U.S. residents. Enter your nine-digit Tax ID number with
no dashes. |
| Taxpayer Id Number Type |
*
Required of all U.S. residents. |
| Tax
Classification |
*
Required for payment purposes |
| Owner
Name (If Sole Proprietorship) |
Required of sole proprietorships. |
| |
Please
double check the information you have entered above for accuracy. |
| |
By
clicking Accept at the bottom of this registration page, you certify that
the information you have entered in the above fields is correct. |
| * Required Fields |
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