Referral Submission Form - Fill in this form to receive my 50% bonus for being my referral!

If you join a site as my referral I will pay you 50% of whatever you earn me from being my referral directly to your PayPal when I cash-out! For example if have earned me $1 as my referral I will pay you 50 cents when I cash-out, it's that simple. You do need to register by using this form to be able to receive this bonus though. Please note if you join LinkGrand or TheClickers there are additional requirements in getting paid which I will send you an email at a more later date.

1. Your Account Name
2. Site Your Registered With
3. Your PayPal Email
4. Your Main Email
5. Date you joined (dd/mm/yyyy)
6. Additional User Information/Comments

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