Advertising Affiliate Application

Advertising Sales Consultant Information Form

This program is currently for people living in the United States Only !!!

Be certain to complete the form accurately. This information will be used for processing payment after you are successful selling advertising space on ApparelSearch.com

The name you enter is the way payment checks will be written.

First Name:

Middle Name: (if applicable)

Last Name:

Type complete mailing address: (this is the address we will use to send checks)

Phone #

Second Phone # (if applicable)

Fax #

E-mail

Web site address: (if applicable)

Company Name (if applicable)

This program is currently for people living in the United States Only !!! If you live in another country and would like to participate, you can e-mail us and we will contact you when the program is available internationally.

By submitting this form, you confirm your understanding and acceptance of the rules, regulations and policies of the Advertising Sales Consultant program.