Application form for Creating a Google Adsense Account (Non-Hosted) - Only for Website Owners
Let you fill all the details below for creating your Google Adsense Account. Tell us the truth, otherwise your account will not be approved. After filling up this form, we will start working for you. Within 48 hours, you'll get an approved Google Adsense account.
Do you have any Adsense Account?
If your answer is "YES", and you want to create another account, then please contact with us.
Your Full Name (As on Bank Account)
Your answer
Your Country
Your answer
Postal Address with PIN
Google will send you a verification code (PIN) by post to the given address. So, please type the address correctly. You know, without verification of your address, your account is incomplete.
Your answer
Don't wary, THEMENTALCLUB always with you. Contact with our Adsense Expert Mr. Biswajit Das
You can contact directly with him.
Skype: biswa209

The Mental Club Contact:
Official Facebook:
Contact via site:
Note: Sometime, we give the support via remote control software as well as "TeamViewer". So, install the latest version of TeamViewer on your PC.

How do you connect with us?
Gmail ID for creating the Adsense Account
Your answer
Phone number (+Country Code)
Note: Give the mobile number which is associate with your Gmail ID.
Your answer
Do you have any other Gmail ID with the above phone number you've given?
Website to approve
Please write the main domain name (Like: Please don't write sub-domain.
Your answer
Age of your Domain?
For editing some contents of your website, we need the admin panel of your website. Do you want to provide us the login info?
Login info means, the user name and the password of admin of your website. You may also add us temporarily as an "Administrator" or "Editor".
How do you want to pay us?
Don't wary, you will get the refund - if we are unable to create your account. This is not a payment form. We will send you the payment link via email. You've to just select the payment method. Note***: If you are from India, then you've to pay only Rs. 3000 Rupees. If you are from outside of India, then you've to pay $50 (USD) only.
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