Full Name *

Please enter your full name

Email Address *

Please enter your main contact email address

Secondary Email Address

Please enter your secondary email address (optional)

Contact Number *

Please enter a contact number

Company Name *

Name of the affiliate(s) you represent

Company Number *

Your main company number

Main Company Web URL *

Link to your company website (i.e. https://www.{spreadex}.com), if you have multiple affiliate URLs, please enter as many as you can

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What is your main business? *

What is the main nature of your business. E.g: Odds Comparison, Reviews etc ..

How do you attract new business/leads? *

E.g. Natural search web traffic, PPC, existing mailing lists, etc.

Are you applying for Sports, Financials or Casino? *

Sports Financials Casino

Will you have an on-going contract with your referrals? *

Yes No

Will you be able to influence the referrals trades? *

Yes No

Will you assist anyone in opening an account? *

Yes No

Will you assist in placing their bets? *

Yes No

Are you FCA regulated? *

Yes No

What date was your affiliate site established? *

Have you been subject to any regulatory or legal action? *

Yes No