LuxSci

LuxSci Affiliate Program Registration

To register as a LuxSci Affiliate, please enter your name, address, and email address below. Your email address will be your login. The "PayPal Email Address" is not required, but if you have one, we can send you commissions via PayPal instead of via check.

Note that we can only send commission checks to addresses in the U.S.A.

Your Name 
Email Address/Login* 
Password* 
  For security reasons, passwords must be at least 6 characters long, contain both letters and numbers or symbols, and not be easily determined by password guessing tools.
Verify Password* 
Organization 
Address Line 1* 
Address Line 2 
City* 
State/Province* 
Zip/Postal Code* 
Country* 
Phone Number* 
PayPal Email Address 
Your Web Site URL 

 

Please type the text seen in the image, below, into the "Security Code" box.

Security Code:

The security code is the text that you see in the image, above. Use of this code helps us prevent abuse of this form by automated programs.