Manual Payment Setup Form

Please fill out the form below so we may receive access to your GLN marketing system and setup your payment methods of your choice. You are responsible to make sure that your user credentials for the payment methods you choose are correct. If you miss out on commissions because your credentials are not correct, you will not be paid on those lost commissions. In most cases we will have your buttons setup rather quickly, but please give us up to 24 hours to set your buttons up unless it is a holiday or weekend.

What is your full name?(Required)