Affiliate Site Creation Information Form

Creating your online Diet Type Affiliate website requires submitting important information. 

The image below shows an example of an Affiliate Website with certain sections labelled to help you understand why the information is being asked.

[wordpress_file_upload createpath="true" uploadtitle="Upload Logo Image" notify="true" notifyrecipients="" attachfile="true"]

Name or quote would you like displayed at the top of your site
The 4 characters you would like your passcodes to begin with. You may choose from A-Z except for B, D, G, I, O, Q, S, Z. All passcodes created are unique to only your site and cannot be used with any other Affiliate website
A web address that will be placed on the Report and Food List
For technical support or dietary questions.
Find your merchant ID at
This is what your User's will pay if they purchase a passcode from your site. You cannot set the price below $19.95.