Affiliate Sign-up Form
Please enter the details below to sign up to the Namshi Affiliate Program
Email address
Company Information
Company Name
Your answer
Address
Your answer
Billing Country
Your answer
Select Payment Option
Bank Account Number:
Your answer
Account Holder Name
Your answer
Bank Name and Address
Your answer
IBAN
Your answer
Swift Code
Your answer
Paypal (if applicable)
Your answer
Contact Information
First Name
Your answer
Last Name
Your answer
Job Title
Your answer
Contact Number
Your answer
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