Apply to Be A BClick Publisher Site

 

Please fill out the form below and your site will be reviewed for inclusion in the BClick network.  If your site is accepted into the network, you will receive an E-mail with your account number and details on how to get started.

 

   Company Name:    
                    (Individual if none)
   Contact Name:    
                    (first and last)
   Contact E-mail:  
   Payee Name:      
                    (full name of who to make checks out to)
   Address:         
                    
   Town:            
   State:            (if in US)
   ZIP:              (if in US)
   Country:         
   Phone:           
                    (please include area code)
   Fax:             
   URL of site where banners will be hosted:
   
   Password:          
   Re-type Password:  
   Additional URL's:
    (other URL's which will be hosting banners.
     only include URL's which are not linked to the URL above)
   


Before submitting this form, please verify the following:

  • The URL you have provided us is live and connects to the actual site where banners will be hosted.

  • The E-mail address you have listed is accurate.  You will receive your welcome E-mail at this address.

  • You have read and agree to our Terms of Service.




 

BClick - A Division of SiteUp, Inc.
Hauppauge, NY 11788
800-883-9050, option 1