Affiliates

Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email*
Phone*
How will you promote Core Health Products?*
Your Website URL

Example: http://www.yourwebsite.com
Core Health Affiliate Profile URL*
This will be used for your referral/web profile URLs and should not contain spaces or special characters (&!#$%', etc.).
Example: CoreHealthProducts OR core-health-products
Username*
Password*
Enter Password Confirm Password
Payment Email*

Used for receiving payout notifications. If you are a PayPal user, we recommend setting this to your PayPal account email address.
About/Bio*
Short introduction your referrals will see when they visit your affiliate profile page.
Profile Image
Accepted file types: jpg, jpeg, gif, png.
Please upload either a .jpg or .png file no larger than 300px x 300px in size.
Who referred you to the Core Health Products Affiliate Program?*
Terms and Conditions*
- Yes, I agree to the Affiliate Terms and Conditions
By checking this box and submitting this form, you agree that you have read and agree to the Affiliate Terms and Conditions.
Comments
This field is for validation purposes and should be left unchanged.