Affiliate Sign Up - Big Win Affiliates

ACCOUNT LOGIN DETAILS

Username *

Required 4 characters.

Password *

Required 8 characters.

Confirm Password *

Required, equals Password.

ACCOUNT PROFILE DETAILS

First Name *

Email Address *

Company Contact Number

Website URL *

e.g: http://www.examplexyz.com

City *

Zip Code *

Teams ID

Required minimum 4 characters

Last Name *

Company Name

VAT Number

Company Number

Contact Number *

Address *

State/Province

Country *

PAYMENT DETAILS

Payment Settings *

Bank Account Details Paypal Details

Full Name *

Company Name

IBAN *

Account No. *

Bank Name *

Swift/BSB *

Address1 *

Address2

City *

State/Province *

Country *

BRAND

	Brand	Website URL
	Cozino	www.cozino.com
	Thor Slots	www.thorslots.com
	Wizard Slots	www.wizardslots.com
	Easy Slots	www.easyslots.com
	Mega Reel	www.megareel.com
	Barbados Bingo	www.barbadosbingo.com
	Slots Baby	www.slotsbaby.com
	Umbingo	www.umbingo.com
	Slotzo	www.slotzo.com
	666 Casino	www.666casino.com
	Dream Jackpot	www.dreamjackpot.com
	King Casino	www.kingcasino.com
	Star Slots	www.starslots.com
	Daisy Slots	www.daisyslots.com
	Slots Racer	www.slotsracer.com
	SlotsUK	www.slotsuk.co.uk
	Pay By Mobile Casino	www.paybymobilecasino.com
	Bezy	www.bezy.co.uk
	Bonanza Slots	www.bonanzaslots.co.uk
	No Deposit Slots	www.nodepositslots.com
	Free Spins No Deposit Casino	www.freespinsnodeposit.casino
	New Online Slots	www.newonlineslots.co.uk
	Giant Wins	www.giantwins.com
	Dove Casino	www.dovecasino.com
	Amigo Slots	www.amigoslots.com
	Egypt Slots	www.egyptslots.com
	Clover Casino	www.clovercasino.com
	VIP Spins	www.vipspins.com
	UK Slot Games	www.ukslotgames.com
	UK Online Slots	www.ukonlineslots.com
	Super Mega Fluffy Rainbow Vegas Jackpot Casino	www.supermegafluffyrainbowvegasjackpotcasino.com
	Rose Slots	www.roseslots.com
	Online Slots UK	www.onlineslotsuk.com
	Money Reels	www.moneyreels.com
	Lion Wins	www.lionwins.com
	Late Casino	www.latecasino.com
	Kong Casino	www.kongcasino.com
	Slot Sites UK	www.slotsitesuk.co.uk
	Free Bet Casino	www.freebet.casino
	Pay By Mobile Slots	http://paybymobileslots.com/
	Online Bingo	http://onlinebingo.co/
	Slots UK.co	http://onlineslots.slotsuk.co/
	Cashcasinocouk	https://www.cashcasino.co.uk/
	Rouletteonlinecouk	https://www.rouletteonline.co.uk/
	Red Casino	www.redcasino.com
	Oreels	www.oreels.com
	Bet442	www.bet442.co.uk
	IvyCasino	https://www.ivycasino.com/
	MrLuck	www.mrluck.com
	Rosecasino	https://www.rosecasino.com/

I accept the Terms and Conditions for Big Win Affiliates programme.

[Note : Mandatory fields are marked with an asterisk (*) ]