Affiliate Application Form

1
Email Address:
example@example.com
2
Phone Number:
Please enter a valid phone number
3
What is the size of your audience?
Please Select
Please Select
0-1000
1000-5000
5000-10000
10000-50000
50000+
Other
4
What are the demographics of your audience?
5
Website URL:
6
Social Media Platforms:
7
Which social media platform has the largest following?
Please Select
Please Select
Facebook
Instagram
Twitter
LinkedIn
YouTube
Other
8
How did you hear about our affiliate program?
9
Why do you want to join our affiliate program?
10
Any other information you would like to share with us?
Should be Empty: