Affiliate Application


 
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A.D.D. Warehouse Affiliate Program

On-Line Application Form

Please enter the information requested below to join the A.D.D. Warehouse Affiliate Program. You will receive approval via email within five business days.

I have read and agree to the A.D.D. Warehouse Affiliate Agreement: 

Site Information

Company or Individual Name:
URL of Site:
Briefly describe your site:

Mailing Address

Address 1:
Address 2:
City:
State:
Province:
Postal Code:
Country:
Phone:

Primary Contact for Affiliate Program

Name (First/Last):
Title:
Phone:  
Fax:
E-Mail:

Accounting Contact

Name:
Title:
Phone:
Fax:  
E-Mail:

Pay To Address

Pay To Name:
Address 1:
Address 2:
City:
State:
Province:
Postal Code:
Country:

Other Information

How many unique users visit your website each month?
How many page views are logged on your website each month?
On what date was your website established?
What is your business tax classification?
What is your social security number (individual) or federal tax id (corporation)?
How did you hear about the A.D.D. Warehouse Affiliate Program?

Choose the banner you would like to use for your site.

Banner 1:

Banner 2:

Banner 3:

Banner 4:


Email:websales@addwarehouse.com
A.D.D. WareHouse
300 Northwest 70th Avenue, Suite 102 Plantation, FL 33317
Toll Free 800-233-9273 Phone 954-792-8100 Fax 954-792-8545
Copyright 1995-2008 A.D.D. WareHouse