Affiliate Reseller Application

Upon receipt of your submission, your desired promo code will be activated within 12 hours and you can begin earning!

1. Contact Name * First Last
2. Business Name *
3. Email *

Confirm Email *
4. Phone * - ### - ### ####
5. PayPal email (to receive commission payments) *
6. Enter your desired PROMO code (must include at least ONE letter) *
Must be between 4 and 10 characters. Currently Entered: 0 characters.
7. Website
8. Are you currently promoting other B2B products or services? *

No Yes, I am promoting the following
If "yes," in what cities, states, or countries are you promoting?
9. Do you currently work with, or have relationships with independent, franchised, or specialty retailers? *
If "yes," please elaborate and include cities, states, or countries