1pcn Affiliate Program - Sign-up Form - e-commerce and internet marketing

1 PC Network Inc.
Member/Affiliate Sign-Up Form

Thanks very much for your interest in signing up as a Member/Affiliate. . .

There is no cost to apply and join as a Member/Affiliate.

Please provide the required fields marked with an asterisk *
(Only first name, last name and email address are required.). Note how the sponsor details below use the first and last name information and email address. Your Affiliate ID will be provided to you via email. Company names or aliases are acceptable.

First Name*

Last Name*

Company/Organization

Street Address

City

State/Province

Zip/Postal Code

Country

Phone Number

Fax Number

Email*

Optional, but may be required for annual tax reporting purposes. Please enter a 9 digit ID number - a Social Security Number or a Federal Tax ID.

Please register me as an affiliate/independent consultant with the company's e-commerce, internet marketing and internet consulting programs.

Your web site URL address (or proposed address) that will provide an affiliate link to the 1pcn.com site

Optional Resume, Comments or Needs - Your business needs, interests, your business background and/or your personal goals/objectives.

Sponsor ID Number

If available and not specified in the field above, who is the person/affiliate who referred you to the company? (your sponsors name or ID number)

Clicking on the Submit Button will signify that you have read and agree to the Terms and Conditions. It will send the application to:

Affiliate Support
1 PC Network Inc.
affiliate_support@1pcn.com E-mail

Your information will kept confidential.

Your sponsor's ID is ps10952.
Pam Stephens pam@stceliascorner.com

Introduction Next - More Details Free Affiliate Sign-Up

last revised: 11/11/01

For more information on this web site, contact your sponsor or
1 PC Network Inc. at www.1pcn.com
Phone: 949-675-9588 or
Fax: 949-675-9599 or e-mail info@1pcn.com.

Copyright © 1997-2001 1 PC Network Inc. All rights reserved.

First Name*
Last Name*
Company/Organization
Street Address
City
State/Province
Zip/Postal Code
Country
Phone Number
Fax Number
Email*
Optional, but may be required for annual tax reporting purposes. Please enter a 9 digit ID number - a Social Security Number or a Federal Tax ID.
Please register me as an affiliate/independent consultant with the company's e-commerce, internet marketing and internet consulting programs.
Your web site URL address (or proposed address) that will provide an affiliate link to the 1pcn.com site
Optional Resume, Comments or Needs - Your business needs, interests, your business background and/or your personal goals/objectives.
Sponsor ID Number
If available and not specified in the field above, who is the person/affiliate who referred you to the company? (your sponsors name or ID number)