Affiliate Application Form

Your Name*

Desired Username*

This is just for login purposes, your referrals will not see this.

Account Email*

Payment Email*

We send payments to affiliates via PayPal. This is is the email address of your PayPal account so we can send these payments, which may be different from the email you use to login to our site.

Desired Promo Code:*

Website URL:

How do you intend to promote Rip-Tie products?*