My Own Cop Affiliate Account Application Form

Please complete this form if you wish to apply for an Affiliate Account at My Own Cop.
Your First Name
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Field is required!
Your Last Name
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Your Mobile Phone Number
Invalid phonenumber!
Invalid phonenumber!
IMPORTANT - Existing MOC Service Users cannot use that email address - It needs to be different!
Your E-mail Address (This needs to be different to your MOC User E-Mail)
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Field is required!
Enter a Password you would like us to set up for you. You can change this once the account has been created
Enter a strong password
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You can create your own Affiliate Code (Subject to admin approval) Please use at least 6 characters
Enter Your Preferred Affiliate Code (Minimum 6 Characters)
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Promo Discount & Affiliate Commission Details

The available discount is split between you the affiliate and the discount you offer customers in your Promo Code. eg: If the agreed total discount was 15%, you could set your Promo Code to give 10% discount and the remaining 5% would be your affiliate commission or vice versa.
Your Promo Code Discount Percentage
Enter what % Discount you want your Promo Code to be set at
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Field is required!
Your Affiliate Commission Percentage
Enter what % Affiliate Commission you would like to set
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Enter Your Company Name (If Applicable)
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Field is required!

Bank Details

Please enter the details of the bank account you wish to have any commissions paid into
Enter The Name On Your Bank Account
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Enter Your Bank Account Number
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Enter Your Bank Sort Code
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Enter Your Bank Name (eg: HSBC etc.)
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Promotions & Marketing

Tell us a little about the kind of marketing and promotional activities you may undertake
Tell us why you would make a great Affiliate Seller
Tell us a little about yourself - Experienced, Just starting out, Want a side hustle? etc.
I'd make a great affiliate because...
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Social Media
Tell us which Social Media you plan to use to promote MOC
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Other Promotional Activities:
Tell us what other (If any) Promotional or Marketing Activities you plan on undertaking
Any other promotions - eg: Google Ads or other marketing activities etc.
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Field is required!
Are you an Online Influencer?
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My Website/Domain
Enter an existing website or domain that you plan on using to promote My Own Cop (If applicable)
http://
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Please Confirm
Please tick & sign to confirm that you have read & understand the Affiliate Terms & Conditions
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Please sign this form with your finger if you are using a mobile. Otherwise use your mouse if on a PC. It doesn't need to be perfect, as long as it is your mark
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Submit