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Affiliates Program

Affiliates Program Application for

Vitalityweb.com, Inc., Backsport Health Products & The-Backstore.com

Submit your application

Before finalizing and submitting your application, please review the Affiliates Agreement, which describes the terms and conditions of your participation in the Affiliates Program. Once you have filled out this form and reviewed the agreement, press the "Yes" button to submit your application or the "No" button to exit.

Payee Information

Please fill out the name and address of the person or company to whom we should make checks payable. Please note that we can only accept one payee name in the box below.

Payee's name:
(Please enter ONLY the name of the person or entity to whom the check should be written)

Address Line 1:
(Enter 'care of' or 'attention' for the name of the person to whom the check should be sent here)
Address Line 2:

City:

State:

ZIP Code:

Phone number:

Payee's e-mail address:

Contact Information

Please enter the name and address of the person to whom we should address all correspondence about your participation in the Affiliates Program.

Contact person's name:

Address Line 1:

Address Line 2:

City:

State:

ZIP Code:

Phone number:

Contact person's e-mail address:


Describe Your Existing Web Site

Enter the name and URL of the Web site through which you wish to link to The-Backstore.com.

Name of your Web site:

Home page URL of your Web site:


Describe Your Intended Listings

Add any other brief comments or questions below:

Description and comments:


Other Information

How did you learn about the Vitalityweb Affiliates Program?
Select One:


By pressing the "yes" button, you indicate that you want to apply to participate in the Affiliates Program, that you have reviewed the Operating Agreement and understand its contents, and that, if Vitalityweb/BackSport Health Products/The-Backstore.com accepts this application, you agree to be bound by the terms and conditions of the operating agreement.

Please single click on this button to apply.

 

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