Publisher Application

Thank you for your interest in becoming part of the Adtegrity.com Publisher Netowrk. Before you continue, please review our PUBLISHER CRITERIA to make sure you qualify to become a publisher. If you meet our criteria, you can get started by filling out the application below as completely as possible. We will review your information and get back to you within 48 business hours.

Adtegrity.com does not accept:

• Sites with any adult content including; nudity and suggestive photos, adult language or decidely adult themes/subjects
• Warez sites, torrent sites, proxy sites, MP3 sites or any other site that does not fully comply with the DMCA.
• Sites that have been stolen or copied from other sites.

For our complete content policy please review our Publisher Criteria.

You will be required to:

• Verify your authority to act on behalf of the site(s) you’ve submitted
• Disclose all URL’s that you intend to run Adtegrity.com ad code on
• Complete tax forms and PayPal authorizations (Internationally based publishers included)

Please fill out the application completely. Required fields are noted with an *.

* Your Site Name
* Name
Title
Company
* Address 1
Address 2
* City
* State/Province
* Zip/Postal Code
* Country
* Phone
Fax
* Email

Please enter the Web site address (URL) for each site you would like to place ads on.

URL
Unique Visitors Per Day?
Unique Visitors Per Month?
Page View per Month?
Banners per page?
Percentage of US traffic?

Provide a brief description of your website.

Description

Provide any demographic information you have about your web site audience (age, race, gender, country of origin, etc...).

Demographics

What categories best suite your site?

Site CategoriesAutomotive
 Celebrity/Fashion
 Education
 Games
 Search
 Women's Interest
 Business/Finance
 Computers/Technology
 Entertainment
 Music
 Sports

What ad sizes can you run on your site?

Sizes I can run468x60
 120x600
 160x600
 300x250
 728x90
 Capped Pops
 Uncapped Pops

Are you currently using an ad server?

Ad Server?YES
 NO

If so, which one? (ie: Direct Media Exchange)

Ad Server

How did you hear about Adtegrity.com?

Heard about

If another publisher referred you, please enter their URL here:

Referred by

What other networks have you worked with in the last 2 years?

Other Networks

Anything else you'd like to tell us to help us make a decision about your site?

Notes

I have read and agree to the Adtegrity.com Terms and Conditions You must agree in order to be considered for network membership.

I agree to TOS:YES
 NO

How would you like to be paid?

Pay me by:Pay me by Check
 Pay me by PayPal

If you selected PayPal you MUST enter a valid PayPal payment address here:

PayPal Email
* Verify