Affiliate Sign-up Form

Help your customers, friends and family enjoy financial freedom. Join the Live Out Loud affiliate program and earn 2% to 5% commissions. Commissions are paid on any applicable programs and products sold from any referrals you’ve made—personally or through your website. Once you are approved as an affiliate, you’ll receive an affiliate number to link to the Live Out Loud website. Or simply have the people you refer provide us with your affiliate number when they call in to speak to a strategist. More details on how to use your affiliate number are available once you are approved and sign in.

Personal Information

Fill out your personal information (fields in bold are required). Why do you need this information?

First Name:
Last Name:
Company:
Checks Payable To:
Email:
Phone:
Address:
Address 2:
City:
State / Province:
Zip / Postal Code:
Country:
Tax ID Number :
Approx. List Size :

Password

Choose a password that will allow you to login to your admin area.

Choose Password:
Confirm Password:

Domains

Enter the domains where you will be linking marketing material from. You can enter either:

an exact path (http://www.domain.com/page.html)
a sub-directory (http://www.domain.com/path/)
or a full domain (http://www.domain.com)

Domain #1:
Domain #2:
Domain #3:
Domain #4:
Domain #5:

Site Categories

Please choose up to three categories that describe your website or websites:

Site Category 1:
Site Category 2:
Site Category 3:

Site Information

Unique Visitors Per Month:
How will you promote our campaigns?
Do You Publish a Newsletter?	Yes No
Number of Subscribers:
Do you send Solo email?	Yes No
Single or Double Optin?	Single Double
Mailing Frequency:
Do you record Time/Date/IP Stamp?	Yes No

Refer a Friend

Enter the email addresses of your friends to let them know about this affiliate program. If they follow the email link here and sign up, they will automatically become part of your second tier! (optional)

Email #1:
Email #2:
Email #3:
Email #4:
Email #5:

I agree to the terms and conditions specified in the Affiliate Agreement

Please add this merchant to my free Kolimbo account to allow for centralized logins and account management.