Rearclick Rearclick Affiliate Registration  
Account Information
Username
  
Password
Verify Password
Primary Contact E-mail
(your primary email: mary@yourwebsite.org or john@xyzcorp.com)

How did you hear about Rearclick?
 
Company Information
Important: This is the address to which Rearclick will send your monthly commissions. If you enter an incorrect address (or change locations and do not update your account) a re-issuance fee will be assessed to cover costs incurred by voiding incorrectly sent checks. This amount will be subtracted from your commissions.

Make Check Payable To
First and Last Name
Company/Organization ex: ABC Inc, YourWebsite.com, Self
Company URL ex: http://www.yourwebsite.com
Country
Address 1
Address 2
City
State
Province/Region
Zip or Postal Code
Phone Information
Primary/Daytime Phone ex: 1-555-555-5551 x123
Secondary/Evening Phone ex: 1-555-555-5552
Mobile Phone    ex: 1-555-555-5553
Best Time to Call   
ex: Primary: 9am-5pm Pacific, Secondary: 6pm-10pm, Mobile: anytime
Tax Information
Tax Classification
In order to receive payment, we must have one of the following forms on file for you or your business:
Foreign - W8: http://www.irs.gov/pub/irs-pdf/fw8ben.pdf
Domestic - W9: http://www.irs.gov/pub/irs-pdf/fw9.pdf
Please complete, sign and mail or fax to Rearclick (be sure to put your username and affiliate id somewhere on the form)