Affiliate Application

Your Name (required)

Company (required)

Your Email (required)

Your Phone

Website or Blog URL (required)

Website or Blog Monthly Traffic (required)

IG Handle (required)

# of IG Followers (required)

YouTube Handle (required)

If you were invited by a current affiliate, please write their name here (optional)

I hereby consent and allow the use of my and/or my company's information, including sharing with a third party, to assess, detect, prevent or otherwise enable detection and prevention of malicious, invalid or unlawful activity and/or general fraud prevention.

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