Dear Affiliate,

Please complete the following form accurately and completely to have your monthly earnings electronically transferred to your PayPal account. Please allow us 3-5 business days to verify your information and setup of your transfer.  If you have any questions, please contact the Affiliate Program Administrator +1 (888) 641-3075.

If you do not have a PayPal account but would like to establish one, click here.  After completing the registration, return to this form and complete the process.

    Your First Name: (required)

    Your Last Name: (required)

    Your PayPal Email: (required)

    Your Phone: (required)

    Your Account Number: (required)

    Last Four Of Your SSN: (required)


    As an Affiliate of CitySpotz Media Corp, I hereby authorize the transfer of my commissions into the above mentioned PayPal account.