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Application Form
* Denotes Required Inputs
Email *
Password *
Password must meet the following requirements:
At least
one letter
At least
one capital letter
At least
one number
Password should be
6 to 20 characters
At least
one special character
Confirm Password *
Password must meet the following requirements:
At least
one letter
At least
one capital letter
At least
one number
Password should be
6 to 20 characters
At least
one special character
Business Name *
State Business is Located *
Business Phone No *
Business License Details
Business Licence Number (Optional)
Expiration Date (Optional)
License Certificate (Optional)
Referral Code (Optional)
Referral Expenses
Referral Pay
MINIMUM is $5 for a referred person
Discount
(product must have a minimum 5% discount)
App’s Fees
($1 - On every successful purchase by user)
Expenses are subtracted from purchases
Product/Service has to be a minimum of $6
SUBMIT
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