Voxwire Sales Rep Account Signup

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Voxwire Affliate Online Application

Date: 2/4/2012

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Thank you for your request to become an Voxwire Affiliate. We look forward to a mutually profitable relationship. Please complete the following form which will create your commission tracking account. Asterisks indicate REQUIRED fields.

Affiliate Info Please choose your Affiliate Username and Password.

It must be between 4 and 20 characters long and only consist of letters and numbers. The Affiliate Username is used within your Affiliate URL (http://secure.voxwire.com/cgi-bin/ua/go.cgi?id=AFFILIATE_USERNAME) so that we may properly track and credit referral commissions to you. The Affiliate Password is used by you to access your Affiliate Account, so that you may track your marketing efforts and referral commissions. These may be the same as your Customer Username and Password unless you want them to be different. Once assigned, your Affiliate Username can not be changed.

Username:

Password:

Verify Password:

Contact Info Enter contact information for the person or company to whom we should make commissions payable.

Company name:

Company Website:
(Include http://)

Full Name:
(Include First & Last Name)

Email:

Phone:

Address 1:

Address 2:

City:

State/Province:

Zip:

Country:

Commission Payment Info Enter information about how you would like to receive Commissions.

Make commission payable to:
(Enter exactly as it should appear on the check.)

Tax ID :
(U.S. citizens or residents only)

Enter your U.S. social security number (for individuals as ###-##-####) or U.S. tax ID (for corporations as ##-#######). U.S. law requires Voxwire to collect tax information from Affiliates who are U.S. citizens, U.S. residents, or U.S. corporations. In addition, if you are not a U.S. citizen or resident, but your business is taxable in the U.S., you must provide us with a completed U.S. Treasury Form W-8ECI. We are obligated to have this information on file in order to make payments.

Submit Application

Your IP address: 38.107.179.207

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