Affiliate Sign Up - Lucky Red Partners

Username *

Required 4 characters.

Password *

Required 8 characters.

Confirm Password *

Required, equals Password.

First Name *

Email Address*

Company Phone Number

Website URL *

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

City *

Zip Code *

Skype ID

Required minimum 4 characters

Last Name *

Company Name

VAT Number

Company Number

Phone Number*

Address *

State/Province

Country *

Payment Settings *

Bank Transfer Neteller Details Skrill Details Crypto

First Name *

Last Name *

IBAN *

Account Number *

Bank Name *

Swift/BSB *

Address (line 1) *

Address (line 2)

City *

State/Province *

Country *

	Brand	Website URL
	Prive Win	https://privewin.com/#/lobby
	REDAXE Play	https://www.redaxeplay.com/#/lobby

I accept the Terms and Conditions for Lucky Red Partners.

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