Affiliate Registration

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E-mail*

Name*

Password*

Must be 6 or more characters and contain at least 1 letter, 1 number and 1 special character (! $ # - .)

Repeat Password*

Website/Social media site

Company Name

Address

City*

State*

Postal code

Country*

Fields marked with * are mandatory

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Welcome to the registration page for Prima Coffee's affiliate program. Please enter your information and you will receive a confirmation email when your account is ready to use. If you would like your commissions paid out through a mailed check, please make sure that the information in Company Name is who you would like the check made out to and the mailing address is where you would like it mailed. If you would like to be paid through PayPal, make sure that the email you enter is the same as your PayPal email. If you have any questions, please email ragan.latour-kelley@prima-coffee.com.