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Eligibility requirements
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Account Information
E-mail
*
Valid email address is required. We will send a Publisher Signup Confirmation email to this address and if your application is approved, you will receive a Welcome Email with a link to set your password. If you do not receive a Publisher Signup Confirmation email, please send us a message using the
contact form
Password
*
Confirm password
*
Provide a password for the new account in both fields.
Contact Information
First Name
*
Last Name
*
Company Name
Phone Number
*
Traffic Information
Primary Traffic Origin
*
- Select a value -
Africa
Asia
Australia
Europe
North America
South America
Through what channels are you going to promote our offers?
*
Email
Web Sites
Blogs
Search
Software
Internet Advertising Agency
Primary Website URL
URL
Average Monthly Unique Site Visitors
Does your site offer incentives?
- None -
Yes, for clicks only
Yes, for offer signups only
Yes, for both clicks and offer signups
No
Category 1
- None -
Auto
Women/Children/Family
Education
Dating/Blogging/Community
Computers and Technology/IT Services
e-Shopping/Free Trials
Games/Entertainment/Music
Sweepstakes/Gambling/Freebies/Surveys
Health/Medical/Beauty
International
Magazines and News
Time Share/ Real Estate/ Home Services
Sports/Hobbies
Travel/Tourism
Business Opportunities/Home Bizz
Legal
Financial - Cash Advance/Credit Cards
Financial - Credit Report
Financial - Debt/Tax relief
Financial - Insurance
Financial - Loans/Grants/Mortgage
Email/Zip/Short-form submits
Careers/Employment
Category 2
- None -
Auto
Women/Children/Family
Education
Dating/Blogging/Community
Computers and Technology/IT Services
e-Shopping/Free Trials
Games/Entertainment/Music
Sweepstakes/Gambling/Freebies/Surveys
Health/Medical/Beauty
International
Magazines and News
Time Share/ Real Estate/ Home Services
Sports/Hobbies
Travel/Tourism
Business Opportunities/Home Bizz
Legal
Financial - Cash Advance/Credit Cards
Financial - Credit Report
Financial - Debt/Tax relief
Financial - Insurance
Financial - Loans/Grants/Mortgage
Email/Zip/Short-form submits
Careers/Employment
Secondary Website URL
URL
Website 3
URL
Website 4
URL
Website 5
URL
Website 6
URL
Website 7
URL
Email Publishers
Do you own or rent your email list?
- None -
Own
Rent
Both
Where do subscribers join the list from?
Is your email list single or double opt-in?
- None -
Single
Double
How many names do you have in the list?
Payment Information
Send Payments To
*
- Select a value -
Company Name
Personal Name
Address
Country
*
Afghanistan
Aland Islands
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
British Virgin Islands
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Caribbean Netherlands
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo (Brazzaville)
Congo (Kinshasa)
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Honduras
Hong Kong S.A.R., China
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Ivory Coast
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao S.A.R., China
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Northern Mariana Islands
North Korea
Norway
Oman
Pakistan
Palau
Palestinian Territory
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russia
Rwanda
Saint Barthélemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin (French part)
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
U.S. Virgin Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
United States Minor Outlying Islands
Uruguay
Uzbekistan
Vanuatu
Vatican
Venezuela
Vietnam
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Address 1
*
Address 2
City
*
State
*
--
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District Of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
--
Armed Forces (Americas)
Armed Forces (Europe, Canada, Middle East, Africa)
Armed Forces (Pacific)
American Samoa
Federated States of Micronesia
Guam
Marshall Islands
Northern Mariana Islands
Palau
Puerto Rico
Virgin Islands
ZIP Code
*
Tax ID / SSN
Payment Method
*
Check
PayPal
Wire
ACH
PayPal Email Address
Bank Info
Payment Threshold
*
$100
$250
$500
$1,000
$1,500
General Information
What do you think we should do to make your site more profitable?
What types of offers do you search for?
Do you have other comments or suggestions?
Where did you hear about Agami Media?
*
- Select -
Affiliate Directories
Search Engine
Press Release
Email From Agami Rep
Other
I want to receive email alerts about new campaigns and changes to existing ones.
I confirm that I have read and agree to the
Privacy Policy
*
I confirm that I have read and agree to the terms of
Agami Media Publisher Agreement
*
What code is in the image?
*
Enter the characters shown in the image.
Publisher websites must be content-based, not simply lists of links or advertisements;
Publisher websites must have top-level domain names and valid WHOIS information. No free hosted sites (using Geocities, Xoom, Tripod, Talk City, and similar free hosting services) will be accepted;
Publisher websites must be fully functional at all levels; no "under construction" sites or sections;
Publisher websites must not contain, promote or have links to any illegal activities or such generally understood as Internet abuse, including but not limited to profanity, sexually explicit or hate materials, violence, any discrimination, software piracy or violations of the intellectual property rights of others or any other materials deemed unsuitable or harmful to the reputation of the Company;
Publisher websites must contain primarily English language content;
Publisher websites must not contain more than one pop advertisement per page (pop-up, pop-under or pop-exit);
Publisher websites must not be promoted through the use of unsolicited bulk email, or allow website members or customers to engage in similar activities through publisher's web site. Websites should not be included in any major spam blacklists.