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E-MAIL

Abundant Earth
Affiliate Rewards Program Application

Your interest in our program is appreciated!

Just complete this application, and then click on "Submit" when ready to send.
You may also print, and then fax your completed application to 360-385-2196.
Currently, we are only accepting U.S. affiliates with high volume web sites with strong health, family, community, and/or environmentally related themes.

 

Your name:

Email address:

Personal and Company Information
You may also fax this form to us at (360) 385-2196
(We are only accepting U.S. Affiliates at this time).

Company Name:
Address: 
City:    State:
Zip:    Home Phone: 
Work Phone:   Fax:
E-mail:
Web Site URL (where links will be posted):
Name of Web Site:


Billing Information:

For tax reporting purposes, we need either a Social Security Number or a Federal Employment Identification Number:
Would you like us to send your referral fee checks to the address above:
    Yes     No       
If "No," please fill in the name address of check recipient in the box provided:


Additional Web Site & Store Information:

Please select the box that best describes your web site:

 Personal Site    For-Profit Business Site     Non-Profit Organization     Food Cooperative     Other: 

Approximately, how much traffic does your web site generate each month? (Please indicate whether these figure represent "hits," "page-views," or "individual URLs."
 Hits     Page-Views     Individual URLs  

This time, please choose the box that best describes the overall theme of your web site or store:

 Environmental     Health or Spiritual     Children or Family
 Community, Cultural, or Ethnic     Other:

In your own words, briefly tell us why you are interested in affiliating with Abundant Earth:

Abundant Earth, LLC
762 West Park Avenue
Port Townsend, WA 98368
Phone (360) 385-2262    Fax (360) 385-2196


Any additional comments?

By pressing the "SUBMIT" button below, you indicate that you have read, understand and agree to the terms provided in the Abundant Earth Affiliate Rewards Program Contract, and if Abundant Earth, LLC accepts this application, you agree to be bound by the terms and conditions of the Abundant Earth Affiliate Rewards Program Contract

 

 

1-888-51-EARTH (513-2784)

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