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Application Form

Please complete this form to register for your Nova88 affiliate account.

Fields marked * must be completed

Contact Information

First Name

Last Name

Gender

Male Female

Email Address

Verify Email Address

Contact Number

Facebook

Mailing Information

Address

City

Postcode/Zip

Country

Website Information

I have my own website

Website URL

I don’t have a website

Please describe how you would like to promote if you don’t have the URL

Preference

Target Country

Language

Security Question

Your Answer

Validation

Payment Information

Payment Method

Nova88 Player Account

Username

I agree to the Terms & Conditions of Nova88 Affiliate.