Affiliate Program :: New Member Application

BY SUBMITTING THIS APPLICATION TO JOIN THE VULTURE KULTURE STORE AFFILIATE PROGRAM, YOU ARE CONFIRMING THAT YOU HAVE READ THE OPERATING AGREEMENT AND AGREED TO BE BOUND BY ITS TERMS AND CONDITIONS, AND THAT YOU HAVE READ AND UNDERSTOOD THE TRADEMARK USE GUIDELINES AND THE PROMOTION GUIDELINES.

Fields marked with * are mandatory.

New Member Application

 
 
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Site Information  
   
Site Name * :
URL of Site * :
   
Personal information  
   
Title * :
First Name * :
Last Name * :
Company :
Date of Birth * :
   
Billing Address  
   
Address * :
City * :
State * :
Country * :
Zip code * :
   
Mailing Address
 
   
Address * :
City * :
State * :
Country * :
Zip code * :
   
Contact Information  
   
Phone * :
E-Mail * :
Fax :
   
Username  
   
Username Option 1 * :
Username Option 2 :
   
Newsletter
  
   
I agree to receive notification of any promotions and future plans!
   
Terms & Conditions  
   
I agree with the Vulture Kulture Store Affiliate Program Terms and Conditions.
I agree with the Rules Regarding Affiliates Communications and Promotion.
I agree with the Guidelines for Using the Vulture Kulture Trademark.
I understand that in order to complete the application to the Vulture Kulture Store Affiliate Program, I have to mail or fax a completed W-9 form within 10 days from today.
I am at least 18 years old.
   
By clicking "SUBMIT" you agree with our Terms & Conditions.
   
   
         
 
Your e-mail address must be valid. We will use e-mail for communication purposes. Therefore, it is essential to provide a valid e-mail address to be able to use our services correctly.

All your private data is confidential. We will never sell, exchange or market it in any way.

For further information on the responsibilities of both parts, you may refer to our Affiliate Program Terms & Conditions.
     
             

 
 
Dan Statler 2003