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Registration Form for Affiliates & Independent Sales Associates

Please indicate by checking below if you agree to the Terms of the Independent Sales Agreement

I agree

 

 

  

You must agree to the following Terms and Conditions in order to proceed.  Please read and/or print the following information.  Click agree and submit to affirm that the facts set forth in this application are true and complete. I understand that if I am accepted as an EQK Independent Representative, any false statements, omissions, or other misrepresentations made by me on this application may result in my immediate dismissal.

Click here to READ the Affiliate Program Agreement (rev 06/09)

Download Affiliate Program Agreement (PDF format)

Click here to READ the Independent Sales Agreement (rev 06/09)

Download Independent Sales Agreement (PDF format)

 


Enter your information below to sign up for our affiliate programs.

 
* First Name:
* Last Name:
* Email:
Company:
Web Site URL:
Address:
Address2:
City:
State/Province:
Zip:
Phone:
* Create a Password:
* Confirm Password:
Paypal Email:
* Affiliate or Independent Sales Rep?
Tell us about your Sales experience
Capabilities and other services you offer
Summarize Special Skills and Qualifications
Describe your strategy to sell EQK products

OUR POLICY:

 

It is the policy of this organization to provide equal opportunities without regard to race, color, religion, national origin, gender, sexual preference, age, or disability.

 

Thank you for completing this application form and for your interest in Emergency Quick Kits.
Affiliate Software by Omnistar