AFFILIATES ON MyNETI.COM
* Required Fields
General Information
Affiliate Program Type
"; if ($option == "1") { echo "
Option 1 - Per Membership Payout"; echo "
Option 2 - Percentage Payout"; } elseif ($option == "2") { echo "
Option 1 - Per Membership Payout"; echo "
Option 2 - Percentage Payout"; } else { echo "
Option 1 - Per Membership Payout"; echo "
Option 2 - Percentage Payout"; } echo ""; ?>
Company Name
Your Website URL
*
If you have multiple websites, list the main one. Please include the http://
Sign In Password
*
Alpha-Numeric Only.
No spaces or special characters.
Re-Enter Password
*
Re-Enter your password for verification purposes.
Your Payment Information
Contact Name
*
Your name, or contact person for your MyNeti.com affiliate account.
Checks Payable To
*
This name will be the "Pay To" on your affiliate checks.
Payment Frquency
*
$35.00 Threshold
$50.00 Threshold
$100.00 Threshold
Your check will be mailed to you when your account reaches this amount.
Contact Email
*
Email address where all corrispondence will be sent. Must Be Valid.
Your Affiliate Account Set Up Information Will Be Sent Here.
Contact Address
*
Address
Address
City
*
State/Province
*
For U.S. Affiliates, us 2 letter state abbreviate
(ex. CA. for California)
Country
*
"; echo "
- Select -"; for ($index=0; $index < count($countrylist); $index++) { echo "
$countrylist[$index]"; } echo "" ?>
Zip/Postal Code
*
Your Business Tax Classification
*
- Select -
Individual/Sole Proprietor
Corporation
U.S. Only.
Tax ID Or Social Security Number
*
U.S. Only - Sole Proprietors: Enter your social security number.
Process Application
Anti-Spamming Agreement
*
Yes, I have read and accepted the MyNeti.com Anti-Spamming Agreement. By clicking a mark in this box you agree to be bound by the terms of MyNeti.com
Anti-Spamming Agreements
.
Affiliate Program Agreement
*
Yes, I have read and accepted the MyNeti.com Affiliate Program Agreement. By clicking a mark in this box you agree to be bound by the terms of MyNeti.com
Affiliate Program Agreements
.