Flickstree - Publisher Form

Company Name *

Company Type *

CIN Number

Affiliate Name (AKA)*

First Name *

Last Name*

Email Id*

Mobile No.*

Office Landline

Building Name/No*

Address1

Address2

Town/City*

State*

Postcode/ZIP*

Country*

Size of business *

Your website title *

Your website URL *

Confirm website URL *

Website status *

Unique Monthly Visitors *

Primary Sector *

Secondary Sector *

Beneficiary Account Name(As per bank records)*

Bank Name *

City *

Branch Location*

MICR Number

IFSC Code*

Beneficiary Type*

Beneficiary Nationality*

Account/ Card Type *

Account/ Card Number*

Confirm Account / Card Number*

I agree with the Flickstree Productions Pvt Ltd Terms of Engagement Agreement.

Publisher Registration desk