Affiliate Registration

First Name:*

Last Name:*

Email Address:*

Password:*

Confirm Password:*

Preferred Coupon Code - Please try and keep this simple.:*

Your Website:

Company Name*

NPO Registration

PBO Number

Physical Address

Can you issue section 18a Certificates*

Yes

No

Social Media Information

Please add your social media handles here, so that we can follow you.

Facebook ID/Link

Instagram Handle/Link

X Username/Link