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Affiliate Application Form
Complete the form below in full, and submit. Failure to complete all fields will not prevent this from coming through to us but may delay your membership if we need to request further information. Your application will be dealt with as soon as possible. You will receive confirmation of application and acceptance is usually within 24 hours - please allow for weekends when work is not undertaken on the Affiliate Scheme. Thank you.
   
Full Name *
Date of Birth / / * (dd/mm/yyyy)
Gender Male Female *
Do you currently run a GoCommerced website? Yes No *
Business Name
Position *
List all of your web sites domain names / urls *
Daytime Telephone No. *
Mobile Telephone No.

Email Address

PLEASE NOTE - This will also become your login username. If this changes the login username remains unchanged, your contact email will be updated.

*

The ways you intend to promote the scheme

 

 

 

 

Adsense style website used mainly for generating income
Blogs
Web Site used for retail / trade sales
Web Site (other) e.g. niche site.
Articles, Editorials, Write-ups & Specialised advertising methods
Using directories, classified ad sites, forums and other available online media.
Via emails/marketing to my customers (must not be spam based email lists and/or spam techniques)
Using business cards in addition to friends/family and on a more personal level with individuals (give details below):
Paper canvassing ads. i.e. Using business cards / postcards / leaflets etc:
Other (give details below)

Further Details

Preferred Payment Method
Paypal Email Address *
Bacs If bacs is your selected payment method, You will receive an email requesting these details separately.
Preferred Response Method if we need further details: We may not respond via your chosen method.
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GoCommerced.Com & GoCommerced.Co.Uk:
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