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VAAM Affiliate Signup Form


Contact Information
Please fill out the name and address of the person to whom we should send referral payments earned through this program, as this information is automatically imported into our database

Note: You must enter a password to protect your account and you must enter the admin contact email address so that we can contact you if required. Also, if you do not have a company name, please leave the value as ABC.

Please complete the entire Application Form below, then click to submit your application. Your application will be reviewed and if it has been accepted you will receive your unique affiliate ID.



Adminstrative Contact Information

Company Name:
First Name:
Last Name:
Address 1:
Address 2:
City/Town:
State/Province:
Postal/Zip Code:
Country:
Phone:
Fax: (Optional)
Email:
Confirm Email:
 Please double check your email address in the above field, as this is where we will be sending you all of your information.


Payee Contact Information

Enter the name and address of the person to whom we should send all payments earned through this program.

Please fill out all of the fields even if they are the same as above, as this information is automatically imported into our database and what you input here will be what name appears on your monthly check and where the check is mailed to.


Click here if info is same as Admin info

Company Name:
First Name:
Last Name:
Address 1:
Address 2:
City/Town:
State/Province:
Postal/Zip Code:
Country:
Phone:
Fax: (Optional)
Email:


 
Tax ID/SSN: (U.S. Residents Only)
Password :
* Write this down!
Password (confirm):

Website URL:
(Optional)
Website Title:
(Optional)
 
Website Description:

(Optional)


Click here to agree to operating agreement. - PLEASE READ.


Once you have filled out this form, press the "Submit Application" button to submit your application.

It is against your associates agreement to advertise VAAM via unsolicated email. Some people think that associate's "spam" email originated from us, damaging our reputation and causing us many administrative problems.DO NOT send unsolicited email to promote VAAM, or you will be in violation of your associate's operating agreement and your account will be terminated, forfeiting all outstanding referral fees.

Your cooperation and understanding is appreciated.


   

If you have any problems with the signup page, please email us.

Copyright 2003 by VAAM Energy. All Rights Reserved

 

 
     
 
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In Affiliation with www.hornetjuice.com
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