{{ heading_title }}

{{ text_my_affiliate }} {{ entry_company }}

{{ entry_website }}

{{ text_payment }} {{ entry_tax }}

{{ entry_payment_method }}

{{ text_cheque }}

{{ text_paypal }}

{{ text_bank }}

{{ entry_cheque }}

{{ entry_paypal }}

{{ entry_bank_name }}

{{ entry_bank_branch_number }}

{{ entry_bank_swift_code }}

{{ entry_bank_account_name }}

{{ entry_bank_account_number }}

{% for custom_field in custom_fields %} {% if custom_field.location == 'affiliate' %} {% if custom_field.type == 'select' %} {{ custom_field.name }} {{ text_select }} {% for custom_field_value in custom_field.custom_field_value %} {{ custom_field_value.name }} {% endfor %}

{% endif %} {% if custom_field.type == 'radio' %} {{ custom_field.name }}

{% for custom_field_value in custom_field.custom_field_value %} {{ custom_field_value.name }} {% endfor %}

{% endif %} {% if custom_field.type == 'checkbox' %} {{ custom_field.name }}

{% for custom_field_value in custom_field.custom_field_value %} {{ custom_field_value.name }} {% endfor %}

{% endif %} {% if custom_field.type == 'text' %} {{ custom_field.name }}

{% endif %} {% if custom_field.type == 'textarea' %} {{ custom_field.name }} {% if affiliate_custom_field[custom_field.custom_field_id] %}{{ affiliate_custom_field[custom_field.custom_field_id] }}{% else %}{{ custom_field.value }}{% endif %}

{% endif %} {% if custom_field.type == 'file' %} {{ custom_field.name }}

{{ button_upload }}

{% endif %} {% if custom_field.type == 'date' %} {{ custom_field.name }}

{% endif %} {% if custom_field.type == 'time' %} {{ custom_field.name }}

{% endif %} {% if custom_field.type == 'datetime' %} {{ custom_field.name }}

{% endif %} {% endif %} {% endfor %} {% if text_agree %} {{ text_agree }} {% endif %} {{ button_continue }}