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<title>Affiliate Program</title>
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<font face="verdana"><B>Affiliate Program</B> - <font color="#000099">Signup</fo
nt></font><P><BR>
<form method="post" action="signup.cgi?tab=complete">
<B><font face="verdana" size="-1" color="red"></font></B>
<table width=60% border="0" cellspacing="0" cellpadding="0">
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<table border="0" width=100% cellspacing="1" cellpadding="1" bgcolor="#000
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<B><font face="verdana" size="1" color="#000099">Contact Infor
mation</font></B>
</td>
</tr>
<tr>
<td><font face="verdana" size="1">Name:</font></td>
<td><input type="text" name="name" size="24" value="[name]"></td
>
</tr>
<tr>
<td><font face="verdana" size="1">Make Checks out to:</font></td
>
<td><input type="text" name="checkname" size="24" value="[checkn
ame]"></td>
</tr>
<tr>
<td><font face="verdana" size="1">E-mail:</font></td>
<td><input type="text" name="email" size="24" value="[email]"></
td>
</tr>
<tr>
<td><font face="verdana" size="1">Street Address:</font></td>
<td><input type="text" name="address1" size="24" value="[address
1]"></td>
</tr>
<tr>
<td></td>
<td><input type="text" name="address2" size="24" value="[address
2]"></td>
</tr>
<tr>
<td><font face="verdana" size="1">City:</font></td>
<td><input type="text" name="city" size="24" value="[city]"></td
>
</tr>
<tr>
<td><font face="verdana" size="1">State/Province:</font></td>
<td><input type="text" name="state" size="24" value="[state]"></
td>
</tr>
<tr>
<td><font face="verdana" size="1">Zip:</font></td>
<td><input type="text" name="zip" size="6" value="[zip]"></td>
</tr>
<tr>
<td><font face="verdana" size="1">Country:</font></td>
<td>
<SELECT NAME="country" SIZE="1"><option SELECTED>[country]</option>
<option>Afghanistan</option><option>Albania</option><option>Algeria</option><opt
ion>American Samoa</option><option>Andorra</option><option>Angola</option><optio
n>Anguilla</option><option>Antarctica</option><option>Antigua And Barbuda</optio
n><option>Argentina</option><option>Armenia</option><option>Aruba</option><optio
n>Australia</option><option>Austria</option><option>Azerbaijan</option><option>B
ahamas</option><option>Bahrain</option><option>Bangladesh</option><option>Barbad
os</option><option>Belarus</option><option>Belgium</option><option>Belize</optio
n><option>Benin</option><option>Bermuda</option><option>Bhutan</option><option>B
olivia</option><option>Bosnia And Herzegowina</option><option>Botswana</option><
option>Bouvet Island</option><option>Brazil</option><option>British Indian Ocean
Territory</option><option>Brunei Darussalam</option><option>Bulgaria</option><o
ption>Burkina Faso</option><option>Burundi</option><option>Cambodia</option><opt
ion>Cameroon</option><option>Canada</option><option>Cape Verde</option><option>C
ayman Islands</option><option>Central African Republic</option><option>Chad</opt
ion><option>Chile</option><option>China</option><option>Christmas Island</option
><option>Cocos (Keeling) Islands</option><option>Colombia</option><option>Comoro
s</option><option>Congo</option><option>Congo, The Democratic Republic Of The</o
ption><option>Cook Islands</option><option>Costa Rica</option><option>Cote D'ivo
ire</option><option>Croatia (Local Name: Hrvatska)</option><option>Cuba</option>
<option>Cyprus</option><option>Czech Republic</option><option>Denmark</option><o
ption>Djibouti</option><option>Dominica</option><option>Dominican Republic</opti
on><option>East Timor</option><option>Ecuador</option><option>Egypt</option><opt
ion>El Salvador</option><option>Equatorial Guinea</option><option>Eritrea</optio
n><option>Estonia</option><option>Ethiopia</option><option>Falkland Islands (Mal
vinas)</option><option>Faroe Islands</option><option>Fiji</option><option>Finlan
d</option><option>France</option><option>France, Metropolitan</option><option>Fr
ench Guiana</option><option>French Polynesia</option><option>French Southern Ter
ritories</option><option>Gabon</option><option>Gambia</option><option>Georgia</o
ption><option>Germany</option><option>Ghana</option><option>Gibraltar</option><o
ption>Greece</option><option>Greenland</option><option>Grenada</option><option>G
uadeloupe</option><option>Guam</option><option>Guatemala</option><option>Guinea<
/option><option>Guinea-bissau</option><option>Guyana</option><option>Haiti</opti
on><option>Heard And Mc Donald Islands</option><option>Holy See (Vatican City St
ate)</option><option>Honduras</option><option>Hong Kong</option><option>Hungary<
/option><option>Iceland</option><option>India</option><option>Indonesia</option>
<option>Iran (Islamic Republic Of)</option><option>Iraq</option><option>Ireland<
/option><option>Israel</option><option>Italy</option><option>Jamaica</option><op
tion>Japan</option><option>Jordan</option><option>Kazakhstan</option><option>Ken
ya</option><option>Kiribati</option><option>Korea, Democratic People's Republic
Of</option><option>Korea, Republic Of</option><option>Kuwait</option><option>Kyr
gyzstan</option><option>Lao People's Democratic Republic</option><option>Latvia<
/option><option>Lebanon</option><option>Lesotho</option><option>Liberia</option>
<option>Libyan Arab Jamahiriya</option><option>Liechtenstein</option><option>Lit
huania</option><option>Luxembourg</option><option>Macau</option><option>Macedoni
a, The Former Yugo-slav Republic Of</option><option>Madagascar</option><option>M
alawi</option><option>Malaysia</option><option>Maldives</option><option>Mali</op
tion><option>Malta</option><option>Marshall Islands</option><option>Martinique</
option><option>Mauritania</option><option>Mauritius</option><option>Mayotte</opt
ion><option>Mexico</option><option>Micronesia, Federated States Of</option><opti
on>Moldova, Republic Of</option><option>Monaco</option><option>Mongolia</option>
<option>Montserrat</option><option>Morocco</option><option>Mozambique</option><o
ption>Myanmar</option><option>Namibia</option><option>Nauru</option><option>Nepa
l</option><option>Netherlands Antilles</option><option>Netherlands</option><opti
on>New Caledonia</option><option>New Zealand</option><option>Nicaragua</option><
option>Niger</option><option>Nigeria</option><option>Niue</option><option>Norfol
k Island</option><option>Northern Mariana Islands</option><option>Norway</option
><option>Oman</option><option>Pakistan</option><option>Palau</option><option>Pan
ama</option><option>Papua New Guinea</option><option>Paraguay</option><option>Pe
ru</option><option>Philippines</option><option>Pitcairn</option><option>Poland</
option><option>Portugal</option><option>Puerto Rico</option><option>Qatar</optio
n><option>Reunion</option><option>Romania</option><option>Russian Federation</op
tion><option>Rwanda</option><option>Saint Kitts And Nevis</option><option>Saint
Lucia</option><option>Saint Vincent And The Grena-dines</option><option>Samoa</o
ption><option>San Marino</option><option>Sao Tome And Principe</option><option>S
audi Arabia</option><option>Senegal</option><option>Seychelles</option><option>S
ierra Leone</option><option>Singapore</option><option>Slovakia (Slovak Republic)
</option><option>Slovenia</option><option>Solomon Islands</option><option>Somali
a</option><option>South Georgia And The South Sandwich Islands</option><option>S
outh Africa</option><option>Spain</option><option>Sri Lanka</option><option>St.
Pierre And Miquelon</option><option>St. Helena</option><option>Sudan</option><op
tion>Suriname</option><option>Svalbard And Jan Mayen Islands</option><option>Swa
ziland</option><option>Sweden</option><option>Switzerland</option><option>Syrian
Arab Republic</option><option>Taiwan, Province Of China</option><option>Tajikis
tan</option><option>Tanzania, United Republic Of</option><option>Thailand</optio
n><option>Togo</option><option>Tokelau</option><option>Tonga</option><option>Tri
nidad And Tobago</option><option>Tunisia</option><option>Turkey</option><option>
Turkmenistan</option><option>Turks And Caicos Islands</option><option>Tuvalu</op
tion><option>Uganda</option><option>Ukraine</option><option>United Arab Emirates
</option><option>United Kingdom</option><option>United States</option><option>Un
ited States Minor Outlying Islands</option><option>Uruguay</option><option>Uzbek
istan</option><option>Vanuatu</option><option>Venezuela</option><option>Viet Nam
</option><option>Virgin Islands (British)</option><option>Virgin Islands (U.S.)<
/option><option>Wallis And Futuna Islands</option><option>Western Sahara</option
><option>Yemen</option><option>Yugoslavia</option><option>Zambia</option><option
>Zimbabwe</option>
</td>
</tr>
<tr>
<td><font face="verdana" size="1">Phone:</font></td>
<td><input type="text" name="phone" size="24" value="[phone]"></
td>
</tr>
<tr>
<td colspan=2>
<BR><B><font face="verdana" size="1" color="#000099">Sit
e Information</font></B>
</td>
</tr>
<tr>
<td><font face="verdana" size="1">Site Title:</font></td>
<td><input type="text" name="sitetitle" size="45" value="[siteti
tle]"></td>
</tr>
<tr>
<td><font face="verdana" size="1">Site URL:</font></td>
<td><input type="text" name="siteurl" size="45" value="[siteurl]
"></td>
</tr>
<tr>
<td><font face="verdana" size="1">Site Category:</font></td>
<td><SELECT NAME="category" SIZE="1"><option SELECTED>[category]
</option><option>Personal</option><option>Business Services/Products</option><op
tion>Index Directory</option><option>Retail/Consumer Goods</option><option>Non-P
rofit</option><option>Entertainment</option><option>Other</option></td>
</tr>
<tr>
<td><font face="verdana" size="1">Amount of Unique Hits per Mont
h:</font></td>
<td><input type="text" name="hits" size="10" value="[hits]"></td
>
</tr>
<tr>
<td colspan=2>
<BR><B><font face="verdana" size="1" color="#000099">Log
in Information</font></B>
</td>
</tr>
<tr>
<td><font face="verdana" size="1">Username:</font></td>
<td><input type="text" name="username" size="12" maxlength="12"
value="[username]"> <font face="verdana" size="1">(must be 5 - 12 characters)</f
ont></td>
</tr>
<tr>
<td><font face="verdana" size="1">Password:</font></td>
<td><input type="password" name="password" size="12" maxlength="
12" value="[password]"> <font face="verdana" size="1">(must be 5 - 12 characters
)</font></td>
</tr>
<tr>
<td colspan=2>
<BR><B><font face="verdana" size="1" color="#000099">Ter
ms and Conditions</font></B>
</td>
</tr>
<tr>
<td colspan=2>
<font face="verdana" size="1"><TEXTAREA COLS=70 ROWS=15 READON
LY WRAP=SOFT>
1. Affiliate Code Presentation
The code we supply you may not be modified in any way including a size change or
any graphical changes as well.
2. Our Rights
We reserve the right to reject any affiliate application that they wish and can
terminate an existing affiliates account without prior notice. We also hold the
right to change aspects of the terms and conditions of our affiliate program and
the properies surrounding the program, such as the commission percentage.
3. Affiliate's Rights
Affiates have the right to recieve their checks promptly and on time on a regula
r basis provided that their commission total exceeds the minimum. Affiliates als
o have the right to receive the proper amount of money that is owed to them acco
rding to their statistics page. Finally, affiliates have the right to discontinu
e their account at anytime.
4. Disclaimer
You hereby agree to indemnify and hold us harmless against any and all claims, a
ctions, demands, liabilities, losses, damages, judgments, settlements, costs, an
d expenses (including reasonable attorneys' fees) (any or all of the foregoing h
ereinafter referred to as "Losses") insofar as such Losses.
5. Terms of Agreement
By signing up for our Affiliate program you agree with every statement on this p
age. This agreement holds true for as long as you are a member of the program an
d you may only receive commissions when you account is still active. Any violati
ons of this agreement will result in the termination of your account and the hol
ding of all your earned money.
6. Frauds and Scams
Anyone who using any technique to try and unfairly make money through our Affili
ate Program will have their account immediately terminated and a lawsuit may be
pressed against the guilty parties.
</TEXTAREA>
</td>
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<td colspan=2>
<font face="verdana" size="1"><input type="checkbox" name="ter
ms"> I have read and agreed to the above terms and conditions
</td>
</tr>
</table>
</td>
</tr>
</table>
<BR>
</center><input type=submit value="Signup">
</td>
</tr>
</table>
</form>
</center>
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