Affiliate Registration | Puprime

Hybrid Registration

Personal Details

First Name*

First Name is too long. First Name cannot have special symbols and numbers. First Name is required.

Last Name*

Last Name is too long. Last Name cannot have special symbols and numbers. Last Name is required.

Country*

Invalid Residency Country Format. Country is required.

Mobile Number*

Code is required. Invalid Mobile number Format. Mobile number is required.

Username*

A Username must be lower-case a-z
Username must be at least 6 characters Username is required. The Username has been registered.

Password*

Your password must be between 8-16 characters and a mix of letters (a-z and A-Z), numbers (0-9), and special characters like !@#$%^&*.()

Please make sure that your password fulfils the security requirements. Password is required.

Email Address*

Invalid Email Format. Email is required.

Affiliate Website Link

This field cannot contain any of the following characters：" < > &

Notes

This field cannot contain any of the following characters：" < > &

Accepted file types: jpg, gif, bmp, jpeg, png, tiff, doc, pdf. Max 50 MB

Proof of Identity (POI)

Drop files here or

Accepted file types: jpg, gif, bmp, jpeg, png, tiff, doc, pdf, Max. file size: 50 MB, Max. files: 3.

Proof of Address (POA)

Drop files here or

Accepted file types: jpg, gif, bmp, jpeg, png, tiff, doc, pdf, Max. file size: 50 MB, Max. files: 3.

This field is hidden when viewing the form

Email Address

Name

This field is for validation purposes and should be left unchanged.

*I Agree to the Terms and Conditions

Note: Residents of the U.S. are not allowed to open an account with PU Prime

Submit