Affiliate Application

Misfits Health Inc
Misfits Health Inc provides Affiliates the opportunity to earn commissions from their website traffic. Affiliates agree to place Misfits Health Inc ads and links on their website in exchange for commission, depending on which Campaign(s) they have joined.

Misfits Health Inc has joined forces with LinkConnector.com to bring you state-of-the-art tracking and reporting on all Affiliate generated traffic. Please complete the following application.
Already a LinkConnector Affiliate? Login here:
Please complete the following application to join the LinkConnector Affiliate Program. * Indicates required field

Website Information
*Website Name
*URL
*Keywords
(255 char)		  (Enter keywords separated by commas.)
*Website
Description
(200 char)
*Category
*How did you
hear about
LinkConnector?
Does your website:
Require a login?  Yes   No
Offer Incentives?  Yes   No

Company Information
*Company
*Phone   Fax 
Tax ID (For individuals, use your SSN - Not a mandatory field for non-US entities)
Tax ID Class
*Online revenue
last 12 months

Mailing Address
*Address 1
Address 2
*City
*State/Province
*Zip/Postal Code
Country

Contact Information
*First Name    MI  
*Last Name
Title
Phone    Fax 
*Email

Username & Password
*Username
*Password  (Password must be 6 to 10 characters long)
*Password  (Please re-enter password to confirm)
*Security Question  
*Security Answer  
*Security Question  
*Security Answer  
* Yes, I have read and accept the LinkConnector Affiliate Terms and Conditions and the LinkConnector Privacy Policy.
Submit