Details:
Full Name
*
First Name
Last Name
E-mail
*
example@example.com
Phone Number
Please enter a valid phone number.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
How did you hear about us?
What was your annual sales revenue in your last full year of business prior to covid?
Do you want to work under our agency name [associate luxe] or under your own brand [affiliate luxe]?
Associate Luxe
Affiliate Luxe
Are you willing to do a background check?
Yes
No
Have you been convicted of a crime or felony?
Yes
No
Please tell us who you hosted with previously and the reason for leaving
Please list your social media links for Facebook, Instagram, Twitter and Linked in
What do you love to sell the most? The least? What do you want to focus on in the future?
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Registration Fee
$
150.00
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
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