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Please fill out and submit the following application as an initial step of enrolling in the Ministry Partners Online Affiliate program.  Fields marked with an asterisk (*) are REQUIRED.  Your website will be reviewed and you will be notified of your application status.


Contact Information
*E-mail Address
*First Name
*Last Name
Company Name
*Address Line 1
Address Line 2
*City
*State
*Zip/postal Code
(Only required within USA or Canada)
*Country
(APO/FPO patrons, please select USA)
*Daytime Phone:
(Include Area Code)
Fax
*Pay Pal Account

Choose how you would like to receive your affiliate commission payments by clicking on one of the radio buttons below:

Affiliate Commission Credit to Pay Pal Account
Affiliate Commission Gift Certificate to this site

Website Information
*What is your Website Address (URL)?
Comments:
Please take a moment and tell us about your site and the kinds of product you plan to list:


How did you hear about Ministry Partners Online Affiliate?
Please type your initials here if you agree to the terms and conditions outlined in the Ministry Partners Online Affiliate Agreement.

Notification of Activation will be emailed to you upon acceptance. Please add MinistryPartners@signaturewebsites.com to your email safe list.





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