PartyPoker - Affiliate Sign Up Form

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Affiliate Sign Up Form

Please complete the following information and submit below. All information is mandatory, except those marked 'Optional'.

If you have a PartyPoker player account, enter your account name here :

Why?

Beneficiary Information

Payments will be made payable to the beneficiary (as written below) to the address provided below.

Beneficiary Name:
Tax ID (Optional):
Mailing Address:

City:
State:
Zip:
Country:

Contact Information

Enter the name and contact information of person to be responsible for the Affiliate Account and above listed Beneficiary.

First Name:
Last Name:
Title:
E-mail Address:
Phone:
Fax (Optional):

Select Login Password

Enter a password to use with your Affiliate ID to login to the Affiliate Section of the site to access stats, find banners, create additional trackers and other functions.

Select Password:
Re-type Password:

Select Tracker Type

Enter the type of Tracker you want to promote with and where it will be promoted. We suggest Sign Up Bonus Codes for offline promotions and Tracking URLs for online promotions. Please note, that you will be able to create additional Trackers of either variety with varying Payment Plans and Sign Up Bonus Incentives once your Affiliate Account has been activated.

	Sign Up Bonus Code, selected as:		(Enter a code name you want to use. No spaces, 1-10 letters and/or numbers)
	Tracking URL

Enter description of where or how you will be promoting the above Tracker.

Select Payment Plan

Enter the payment plan you want applied to the above selected Tracker for purposes of calculating payment due to you.

	20% - 25% Gross Revenue Percentage Plan
	$65 - $75 Per Sign Up Plan

Select New Player Sign Up Incentive

Enter the type of Sign Up Bonus Incentive you want, if any, to be used with your Tracker. If you are promoting with a Sign Up Bonus Code, we strongly suggest using an incentive to ensure that your players will enter your Sign Up Bonus Code when opening their account (so you get credit) whereas with a Tracking URL it is not necessary because your players are automatically tagged with your Affiliate ID when they enter the website.

	20% up to $100 Extra on First Deposit
	$25 Extra on First Deposit
	Free Entry to the PartyPoker Million Qualifying Tournaments ($25 Value) with First Deposit
	None

Please note:
Bonus offers are created for 3 months, and are automatically extended in 3-month intervals if there are real signups through the tracker. Bonus offers with no signups in 3 months will expire automatically, after which, players coming in through the tracker will not receive the bonus.

If you are promoting under the Gross Revenue Percentage Plan, please note that the Bonus Amount is deducted in calculating Monthly Gross Revenue and is therefore shared, pro rata, between Affiliate and PartyPoker

Select Payment Method

Select the manner in which you want to receive your monthly payments.

Check/ *ACH.

Paypal (mailed to above E-mail address)

NETeller

Into my PartyPoker Account (Recommended Option - Its Quick, Easy and Fast).

Wire Transfer ($35.00 fee)

Please provide more payment information, (Paypal email ID/NETTeller email ID, PartyPoker Account Name/Wire Instruction) here :

If you don't have a PartyPoker Account - Open now!

* We cannot release payment through Checks to affiliates based in US.If you are based in US, please give us your ACH information (Your Bank account number, address linked to the bank account and ABA number).

	I have read and agreed to the Affiliate Agreement.

Earn $100 EXTRA in October TOO!

If you have 5 or more real players this month over September 2003, take home $100 over and above your October 03 Affiliate Revenues.
If you have 3 or more real players this month over September 2003, take home $50 over and above your October 03 Affiliate Revenues.

Please note : If you have registered for the PartyPoker Affiliate Program in October 03, you will need a minimum of 5 players to qualify.

Contact affiliates@partypoker.com for more details


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