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Affiliate Program - Application Form

 

Application Form

 

 

Getting started is easy. Just follow the simple steps to fill out the form below. Please complete the form accurately and completely so that we may process your application as quickly as possible. All information is kept confidential.

Check here to indicate that you have read and agree to the terms of the Affiliate Agreement.
 
 
Primary Email: Enter the email address that we should use for all correspondence. Please double-check to ensure that your email address is entered correctly.
Primary Email:
*   
     
Payee: Please enter the contact information for the person or company to whom we should make checks payable.
Payee Name:

* 
Enter the name EXACTLY as it should appear on the check.

 
Address line 1:
*   
Address line 2:
 
Address line 3:
 
Address line 4:
 
City:
*   
State, province or region:
*   
Zip or Postal Code:
*   
Country:
*   
Phone Number:
*     
     
Contact: Please enter the contact information for the person responsible for maintaining your Web site. For most affiliates, the Payee and Contact are identical.
Check here if your Payee and Contact information are identical, and then skip to the next section.
Contact Name:

 

 
Address line 1:
   
Address line 2:
 
Address line 3:
 
Address line 4:
 
City:
     
State, province or region:
     
Zip or Postal Code:
   
Country:
   
Phone Number:
   
     
Web Site : Please enter the information related to your web site where you will be placing the links to Interdesigner.com.  
Web Site Name:
*  
Web Site URL:
*  
Web Site Description:
*
Tell us what you site is all about, it's target audience, etc.
 
Web Site Statistics:
*
Provide us with relevant statistics about your Web Site. You must include at least the following statistics: Unique Visitors per month and Page Views per month.
 
   
* Fields marked with asterisk are required.  
     

    

 


 

(Click Submit Agreement just once, your
request will be processed and you'll return
automatically...THANKS!)

 

 

 

 

 
 
 
 
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