Affiliate site information:
Your Websites:	domain names - one per line
# Visitors:	per month (numeric only)
Desired Plan:	Performance Based Click-through Hybrid Click-through Based
Payment information:
Company Name:	checks will be made payable to this name!
PayPal ID:	(not required)
Administrator First Name:
Administrator Last Name:
Administrator Email:
Administrator Phone:	numeric with dashes - no country code
Payment Address:
Payment Address Cont:	(not required)
Payment City:
Payment State/Province:
Payment Postal Code:
Payment Country:	USA CANADA MEXICO
Login Information:
Username:	8-20 characters, alpha/numeric only
	I am the administrator listed above I am NOT the administrator       my first name:              my last name:              my email address:
	I have read and understood the terms of service for ArtisansMarket Affiliates.
	I have supplied true and accurate information and am authorized to act on behalf of the listed websites.
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