400Affiliates: Create Affiliate Account

At 400 Group we take pride in building and maintaining relationships with our affiliate partners. Please ensure that all your contact details are entered correctly so we can work together every step of the way.

Create Affiliate Account

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Company Information

Business Type:
Company Name*:		Owner Name:

Website Information

Website Name:		Website URL:
Website Type:		Website Category:
Website Visitors:

Personal Information

Username*:		Title:
First Name*:		Last Name*:
Birthdate*:
E-mail*:		Email Preference:
Password*:		Security Question*:
Confirm Password*:		Answer*:

Address Information

Address*:		Home Phone:
Address2:		Work Phone*:
City*:		Cell Phone:
Country*:		Fax:
Zip/Postal Code*:		Province/State*:

Payment Preferences

Payment Method*:
Account Number*:
Account E-mail*:
Expiry Date*:
PAN*:
Payee Name*:
Payee Address*:
Bank Name*:
Bank Address*:
Account Type:
Bank Routing*:
SWIFT:
IBAN:
Extra Bank Info:
Casino:
Login Name*:

Reporting and Marketing

E-mail Subscription	Frequency	Subscribed
Commission Paid This will send an e-mail after your commission has been paid.	Transaction
Player Deposit This will notify you each time a new referral of yours places their first deposit..	Transaction
Weekly Signups Summary A weekly summary showing all your new referrals for the week.	Weekly
Revenue Summary A report summarizing all your affiliate revenue for the month.	Monthly

400 Group Newsletter	Monthly
400 Group Marketing News	Bi-Weekly
400 Group Casino News	Weekly

Terms & Conditions

Where did you hear about us?*

I have read and agree to the: Affiliate Program Terms & Conditions.*

400Affiliates

Create Affiliate Account

E-mail Subscription

Frequency

Subscribed