|
| Primary E-mail: Please enter the E-mail address that we should use for all correspondence regarding payments, improvements in the HistoricAviation.com Affiliates Program. This email address will be your login password. |
Primary E-mail: (username) | |
| Password |
Choose a password: (Max.16 characters) | |
| Please re-enter your password: | |
|
| Payee: Please enter contact information for the person or company to whom we should make checks payable. |
| Payee name: | Enter the name exactly as it should appear on the check. If the check is to be mailed to an individual other than the Payee, enter "Attention:" and the name of the recipient in "Address 1" below. |
| Address line 1: | |
| Address line 2: | |
| City: | |
| State, province, or region: | |
| Zip or postal code: | |
| Country: | |
| Phone number: | |
|
| Contact |
| Name: | |
| E-mail: | |
| Phone number: | |
|
| Describe Your Web Site |
| Is this a personal, business, or other type of web site? | Business ---- Personal ---- Other (museum,etc.) |
What is the name of your Web site? | We will use your Web site name to create a unique ID for you with a maximum length of 16 characters. |
What is your Web site URL? | |
How did you learn about the Associates Program? | |
| Your Intended Listings |
| Description & comments: Briefly describe your site, including the type of items you intend to list. (try to keep this under 10 lines or so) |
| |