Create Affiliate Profile

Press "Continue" button when finished.

Your username cannot be changed and will be visible to all users. It should begin with a letter and may only contain digits, underscores, or decimal points in addition to letters. It may not contain spaces.

Username (screen name):
 

Password must be at least 4 characters long.

Choose password:
 

Please verify your password by re-typing it.

Retype password:
 

A valid email address is required to join the BitWine Network.

 

The name of your business or organization.

Business Name:
 

Your business or organization's physical mailing address. Please separate lines with a comma.

Address:
 

The phone number at which your business can be reached during business hours.

Phone Number:
 

The person who will represent your business when communicating with BitWine.

Contact Person:
 

Receive payments via PayPal:


In order to get paid you need to connect your PayPal account. Please enter the email you use with PayPal.

PayPal Email:
 

Please verify your PayPal email by re-typing it.

Retype PayPal Email:
 

 

Check to confirm you have read and agree to BitWine’s Terms of Service and Privacy Policy

Accept Terms of Service and Privacy Policy
 
 

()   Mandatory Field