Website Builder Program Affiliate Application

Affiliate Program Application

�Home URL� The URL of your web site	�
� �Password� The Password to login to your Affiliate Account	��Enter password ��Confirm password
��	�

Important: We use AffiliateShop.com, a third party service, to monitor and track referrals. If you are an existing member of AffiliateShop,
please fill in the following section:

��E-mail�

To confirm your signup, enter your CURRENT PIN

Current existing members do not have to fill in the next section since
they have already supplied their particulars during their initial signup.

Important: If you are a new member, please fill in the following section:

* �E-mail�

* �PIN�
PIN is required for verification each time you change your personal particulars. It is different from the password value.

��Enter PIN
��Confirm PIN

* �Contact name�

* �Payee name�
The check will be made payable to this name.

�Company�

�Social Security Number�
Applicable to US residents only. Optional.

�Address�

�Street�

�City�

�State�

�Country�

�Zip�

�Contact�

�Phone number�

�Fax number�

To confirm your signup and registration, click on the "Proceed" button. �

��Enter password
��Confirm password

Important: We use AffiliateShop.com, a third party service, to monitor and track referrals. If you are an existing member of AffiliateShop,
please fill in the following section:

To confirm your signup, enter your CURRENT PIN

Current existing members do not have to fill in the next section since
they have already supplied their particulars during their initial signup.

Important: If you are a new member, please fill in the following section:

* �E-mail�

* �PIN�
PIN is required for verification each time you change your personal particulars. It is different from the password value.

��Enter PIN
��Confirm PIN

* �Contact name�

* �Payee name�
The check will be made payable to this name.

�Company�

�Social Security Number�
Applicable to US residents only. Optional.

�Address�

�Street�

�City�

�State�

�Country�

�Zip�

�Contact�

�Phone number�

�Fax number�

To confirm your signup and registration, click on the "Proceed" button. �

��Enter password ��Confirm password

Important: We use AffiliateShop.com, a third party service, to monitor and track referrals. If you are an existing member of AffiliateShop, please fill in the following section:

To confirm your signup, enter your CURRENT PIN Current existing members do not have to fill in the next section since they have already supplied their particulars during their initial signup.