* You must be at least 13 years of age
to register. If you are under 18, you will also be required to fill out a
Parental Consent Form in order to receive payment.
Please
fill out the following form to sign up for a free membership to
DesktopDollars.com. All information inputed into this form is kept safe and
secure according to our privacy
policy. You must fill-in a valid name, emailaddress, and mailing
address to be eligible for payment. Afterall, if we don't know who you are or
where to send the check, how can we pay you?
(*)
Denotes a required field.
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(*) Email address:
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(must include @ and .)(no apostrophes or spaces)
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(*) Confirm email address:
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(must include @ and .)(no apostrophes or spaces)
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(*) Choose a user name:
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(between 4 and 14 characters, alphanumeric)
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(*) Choose a password:
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(between 4 and 14 characters, case sensitive)
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(*) Confirm your password:
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(between 4 and 14 characters, case sensitive)
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(*) First name:
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(*) Last name:
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Middle Initial:
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Suffix:
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(Jr., III, etc.)
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Company Name:
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Website Owners:
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Check this box for info on how to use your website to refer people.
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For APO or FPO addresses, please enter APO or FPO in the
City field and one of the following two-letter codes in the International State/Province field: AE for
Armed Forces Europe, Middle East, Africa, and Canada; AA for Armed Forces
Americas; and AP for Armed Forces Pacific. Lastly, select the "U.S.
Military from the Country field.
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(*) Address 1:
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Address 2:
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(*) City:
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(*) State/Province:
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(*) Zip/Postal Code:
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(*) Country:
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NOTE: If your country is not listed, you CANNOT register.
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(*) Birthmonth:
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(*) Birthday:
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(*) Birthyear:
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* You must be at least 13 years of age to register.
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