Affiliate Sign Up - Bolt Affiliates

Username *

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Password *

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Confirm Password *

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First Name *

Email Address *

Company Contact Number

Website URL *

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

City *

Zip Code *

Skype ID

Required minimum 4 characters

Last Name *

Company Name

VAT Number

Company Number

Contact Number *

Address *

State/Province

Country *

Payment Settings *

Bank Account Details Paypal Details

First Name *

Last Name *

IBAN *

Account No. *

Bank Name *

Swift/BSB *

Address1 *

Address2

City *

State/Province *

Country *

	Brand	Website URL
	Money Reels	www.moneyreels.com
	Rose Slots	www.roseslots.com
	Egypt Slots	www.egyptslots.com
	Clover Casino	www.clovercasino.com
	Kong Casino	www.kongcasino.com
	VIP Spins	www.vipspins.com
	Amigo Slots	https://www.amigoslots.com
	UK Slot Games	https://www.ukslotgames.com
	Lion Wins	https://www.lionwins.com/
	Late Casino	https://www.latecasino.com/
	Giant Casino	www.giantcasino.com
	Dove Casino	www.dovecasino.com
	Super Mega Fluffy Rainbow Vegas Jackpot Casino	www.supermegafluffyrainbowvegasjackpotcasino.com

I accept the Terms and Conditions for Bolt Affiliates programme.

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