Form cover
Page 1 of 3

Application: Affiliate Program

Duration: 1-2 minutes
Thank you for your interest in the affiliate marketing program. In order for us to properly assess your application, we require a few details from you. After you fill out this short form, we will review your application and follow-up with the contract and terms, if you are approved. If you have any questions, please feel free to contact us at [email protected].

Your Information:

First Name:

Last Name:

Email Address:

Country:

City:

Are you looking to register as a business or an individual?

Are you looking to register as a business or an individual?
A
B

Phone Number: