Affiliate Registration

Name*

First Last

Please provide a sentence or two about the work you do so we can know you are legitimate:*

Username*

This will become part of your affiliate link that you provide to your clients/customers. ex: https://rachelyellin.com/ref/USERNAME

Password*

Enter Password Confirm Password

Profession and/or Name of Business*

Preferred Email for Communications*

Phone*

What part of the country do you live in? (City, State)*

Would you like to receive referral a bonus?*

Email address to which you would like to receive PayPal payments:

Please provide the business name or first and last name of the person who referred you to Rachel's Affiliate Program.*

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