Love Dollars - Adult Dating Affiliate Program

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Geo Banners

AdultLoveLine Geo Banner

EbonyLoveLine Geo Banner

LonelyWivesDatingClub Geo Banner
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Account Information

Login/Account Name:	(Your account name must be at least 4 characters long and no longer than 20)
Password:

Personal Information

    First Name:
    Last Name:
    Physical Address Line 1:
(Please make sure your address is entered correctly and remember No P.O Boxes Allowed)
    Physical Address Line 2:
    City:
    State or Province:
    Zip or Postal Code:
    Country:
    Phone Number:
  Non-US Include Country Code

    Age:
     Check to confirm that you have or have had a valid credit card

Contact Information

    E-mail Address:
(Your email address will be used as a main point of contact for your account. Make sure you enter it correctly)
    ICQ #:
    Webmaster Representative:

Payment Information

    Payable To:
    UNITED STATES RESIDENTS ONLY: REQUIRED FOR PROCESSING
    TAX ID Number / SSN:

Payment Details

    Select Pay Method:
(Choose your preferred payment method. Note the fees and minimum payouts associated with each method)

    Minimum Payout:
  Must be at least $5

    Fees: None

    Minimum Payout:
  Must be at least $100

    Notes: Fedex does not deliver to PO Boxes
    Fees: $20 US and $40 International

    Epassporte Username:
    Minimum Payout:
  Must be at least $100

    Fees: None

    Minimum Payout:
  Must be at least $500

    Bank Name:
    Bank Address:
    Bank City:
    Bank State:
    Bank Zip:
    Bank Country:
    Routing (ABA/Swift):
    Account Number:
    Notes: Transferring/Beneficiary Bank Info Not Needed
    Fees: $25 US and $50 International
    Notes: Foreign wires are sent the Tuesday after the 10th
Domestic wires are sent on the Tuesday following the sat payout

Site Information

    Site URL and name is used to verify that you have an approved traffic source

    Your Site Name:
    Your Site URL:

Check if you want to signup for Zoomfree Hosting

NOTE: ANY spam or net abuse complaints will result in immediate account termination and denial of payment. We also reserve the right to litigate such matters if they are deemed to be the cause of tortious interference to our network. Trafficcashgold also reserves the right to recover any damages caused by any such occurrences.

Please read the Terms of Service before you submit this form.

By submitting this application you certify that the information provided is true and correct. You acknowledge reading and accepting the Love Dollars Terms and Agreements, and that you are applying for a webmaster account. You agree that your printed name below constitutes signature.

PRINT YOUR FULL NAME USING YOUR FIRST AND LAST NAME AS ABOVE WITH A SPACE BETWEEN THEM:

Note: If the first name and last name do not match you will not be signed up.