Affiliate Program Signup

You are signing up for Energy Enhancers.

We pay our Affiliates via Western Union in the U.S.A., and Worldwide.

We send cash to any Country and we also pay via Bank Account Transfer. You will need a Driver's License or Proof of Identification (Passport's, National ID's, etc.) to pickup cash at a Western Union payment location. There are more than 500,000 Western Union Payment Locations Worldwide, in over 200 Countries. Find one near you.

First Name: *

Middle Name:

Last Name: *

Suffix:

Address: *

City:

State:

Providence:

Zipcode:

Country: *

Payable to Name: *

This is the name on your Bank Account, Driver's License, Passport, National ID, etc.

You can choose to pickup cash at a Western Union location, or have the funds sent to your bank account. We will send a payment confirmation with tracking number for each payment type. Enter your Bank details if payment method Bank Account is selected, or select payment type Cash to be paid in cash at a Western Union payment location. Cash will be held at the payment location for only 90 days.

Payment Method: *

Bank Name:

Leave Blank if payment method is Cash.

Bank Account Number:

Leave Blank if payment method is Cash.

Bank Routing Number:

Leave Blank if payment method is Cash.

Affiliate Photo:

(For Affiliate of the Month. Photo will be displayed 175 X 175 pixels on Corporate Webpage, in the Affiliate Program, and also on several other News and Media outlets in the future.)

E-Mail Address: *

E-Mail Notification:

Commission	Referral Bonus
Residual Commission	Payment

Website:

Password: *

Password verify: *

Enter Verification Code: *