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Application form or "How to become affiliate"

What is the name of the agency?
Email address:
Office physical address
Country:
City:
Address:
Mailing address:
Office phone:
Office Fax:
Web Site (if presents):
Who is the owner of the business?
Full name:
Email address:
Home Address:
Work Telephone:
Home Telephone:
Other information
The name of the person who will be processing Email Forwarding Service:
The name of the person who will be processing the Gift Delivery:
What Banking details should be used to send your company money?
What companies have you cooperated with in the past?
What companies are you cooperating with now?
What size is the database of your agency (how many womens profiles)?
The antibot code: 
Please confirm the antibot code: 

After you submit this form on line you will receive the number for your test. Please use this number when sending the test for Profile submission and photo submission.

You will be also offered to download the operating instructions and How To Succeed document in 2 languages: Russian and English. Please download them if you have not received them already.