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LLAD Membership Application
1
I am a...
Social Media Influencer
Cam Model
Adult Products Retailer
Adult Products Distributor
Other
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2
Name
*
This field is required.
First Name
Last Name
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3
E-mail
*
This field is required.
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4
Phone Number
Area Code
Phone Number
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5
Company Name
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6
Number of Followers or Reach
*
This field is required.
Specify the total number of followers you have across all channels.
1 - 100,000
100,000 - 500,000
500,000 - 1,000,000
1,000,000+
1 - 100,000
100,000 - 500,000
500,000 - 1,000,000
1,000,000+
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7
Social Media Platforms
Specify the platforms you use most to connect and engage with your audience
YouTube
Instagram
TikTok
OnlyFans
Chatterbate
Facebook
Pinterest
Twitter
Snapchat
Other
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8
Social Media Handles
Specify your username or public link for each of the platforms you are on.
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9
I have an existing Shopify store
*
This field is required.
YES
NO
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10
Shopify Store URL
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11
What is the best time to reach you?
*
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12
Preferred Contact Method
*
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Phone
Text
Email
Other
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13
Comments or Notes
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