Merchant Application



Please complete the following application to join the LinkConnector Merchant Program

* indicates required fields.

Website Information

*Website Name
*URL
*Keywords
(255 char)
 (Enter keywords separated by commas.)
*Website
Description
(200 char)
*Category
*How did you
hear about
LinkConnector?
Does your website:
Require a login? Yes  No
Offer incentives? Yes  No

Company Information

*Company
*Phone   Fax 
Tax ID (For individuals, use your SSN - Not a mandatory field for non-US entities)
Tax ID Class
*Online revenue
last 12 months

Mailing Address

*Address 1
Address 2
*City
*State/Province
*Zip/Postal Code
Country

Contact Information

*First Name    MI 
*Last Name
Title
Phone    Fax 
*Email

Account Type

*Account Type Self-Managed  Co-Managed        More Information
Self-Managed Account Benefits
Account Setup Fee None
Annual Renewal Fee None
Network Access Fee $500
LinkConnector Transaction Fee 20%
Exclusivity Requirement and Contractual Term Commitment None

Payment Method


Account Replenishment

Please select a Threshold and Replenishment Value for your account. The Threshold determines the point at which you will be charged your Replenishment Value. For example if you set your Threshold Value to $100 and your Replenishment Value to $200 and your account balance drops to $65, because it is below the Threshold Value of $100, you will be charged the Replenishment Value of $200 bringing your balance to $265.
Note: Your account will not be accessible until payment is received.
*Threshold Value
*Replenishment Value

Username and Password

*Username  (Username must be 6 to 10 characters long)
*Password  (Password must be 6 to 10 characters long)
*Password  (Please re-enter password to confirm)
*Security Question  
*Security Answer  
*Security Question  
*Security Answer  
* Yes, I have read and accept the LinkConnector Merchant Terms and Conditions and the LinkConnector Privacy Policy.


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