Effex Media: Leading Provider of Adult Shopping Partnership Programs

Welcome new affiliate! You are about to begin the store set up process. Creating your own adult store is simple, fast and best of all COMPLETELY FREE!

The first step in the set up process is filling out this form completely. After you submit this form your account will be created automatically and you will receive an email containing your affiliate login and password. You can use your login and password to access the back-end system where you will be able to configure and customize your adult store, the next step in the store set up process.
* indicates a required field.

Contact Name: *
Select your password: * (Minimum of 6 alpha-numeric characters, at least one number and one letter.)
Retype this password: *
E-mail address: *
Payee Name: * (Full name of the payee to which your store earnings check will be payable to)
Company Name: *
Tax ID Code: * (If you are a United States company or citizen enter your Social Security or Federal Tax Id.)
In accordance with Federal Internal Revenue Service Regulations, we are required to have a Completed W-9 Form on file for each of our affiliates. Please complete all the necessary information on the W-9 form and return it to our offices as soon as possible, you can also fax us at (609) 426-8941.
Phone Number: *
Address: *
Suite or Apartment Number:
City: *
State: * (Inside US only)
Zip Code: * (If outside US enter postal code)
Province: (Outside US Only)
Country: *

How did you hear about us? (Pick one.)*

Verify the letters you see above (no numbers)*
I have read and agree to the Terms and Conditions. (You cannot continue if you uncheck this box.)