Affiliate Signup Form

Please be sure to review the terms and conditions page for full details. All applications will be reviewed by a person before an account is created.   Once approved, you will receive a welcome email.

Your Name (required)

Your Email - Please use Paypal Email (required)

URL:(required) (Please use your website URL or main social media platform address you will use to promote Example: https://www.facebook.com/MadRatBevco OR http://www.madrat.com )

Street:

City:

State:

Country:

Zipcode:

Additional Details or URLs Please provide any comments detail or any additional URLs you may use to promote in the text field below. Check Terms and Conditions for acceptable use guidelines.

Please Read Terms and Conditions so you understand our requirements and details of the program then accept below.

Accept Terms:

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(If not clickable first press accept terms checkbox above)