Partner Number:

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Affiliate/Client Sign-Up Form

PRIMUS Affiliates should use this form to sign up new clients and receive commissions for each account. Carefully complete this form, then click on the "Sign-Up" button at the bottom of this page.

Please remember the following:

  • Affiliates must sign up clients one at a time using this form. PRIMUS provides a backlink on the confirmation page to allow you to return to this form.
  • Once you have completed signing up clients, you still must contact PRIMUS customer service to activate the accounts and receive passwords.
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Customer Information
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Please give us some basic information about the person you are signing up for PRIMUS service.
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If you are adding services for a current PRIMUS client, check this box and insert the client's PRIMUS Account Number below

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If you used the above fields for a current PRIMUS client, you do not need to fill out the Client Information section below.
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Name .
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Company .
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Address .
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City/State/Zip .
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Country .
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Phone .
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Email .
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Type of Account Wanted
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Please indicate the type of PRIMUS account your customer wants to purchase. Please choose no more than one service from each box.
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Access Services
 Host Services

 
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Who to Contact to Set-Up Service? .
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Client   Affiliate
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Domain Name Service  (Host Services Only)
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Please enter the Virtual Host address in the space provided. A Virtual Host address should be the domain name prepended by "www.". (Host Services Only).
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Do not fill out this section unless you have already searched for and registered domains via our DNS Pages.
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Virtual Host Address:        
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User Name (Dial-Up/Shared Host Services Only)
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Enter the servicename you want for your account. This will also be used for your email address if the account is an access account. For example, if you choose the servicename "harry", your email addr ess will be "harry@primushost.com". Usernames must be all lowercase alphabetic and/or numeric characters, up to 8 characters in length.
Username .
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Submit Order
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Click on the "Submit Order" button below to submit your request to PRIMUS We'll be asking you for some personal information before we process your request. Use the "Clear" button to erase the entries above and start again.

  

After you submit your request, you must contact PRIMUS to finalize set-up of your account and get your password. Call PRIMUS Sales at (781) 477-2000.