AffiliateFitness.com                                        
501-A  West Colfax St. / Palatine, IL  60067                                                
Tel: 847-963-8969  /  Fax: 847-963-8966                
Email: info@affiliatefitness.com                
Web: www.affiliatefitness.com                
                                                     
NEW AFFILIATE MEMBER SIGN-UP        
DATE:
SEND TO:                                                               
NAME:                                                               
COMPANY:                                                               
STREET ADDRESS:                                                               
CITY/STATE/ZIP                                                               
PHONE:        (                )                                                      
FAX NUMBER:        (                )                                                      
EMAIL:                                                               
WEB-SITE:                                                               
WEB-SITE (alternate):                                                               
TAX ID / SS #:       
                                                     
METHOD OF PAYMENT: (optional) If you want to keep a credit card on file.                  
Name:                                                             
Visa/MC/Amex/Disc                                                               
Signature:                          Expire:                                    
                                                     
PRODUCTS YOU ARE INTERESTED IN:
                                     
                                                             
                                                             
                                           
                                                             
                                                             
                                                             
NOTES:
                                                     
Please fill out as complete as possible.  Fax or email to us.  Make sure to list your web-site(s).
You will be assigned a Password and a link to monitor all sales.                           
Direct a link from your web site to the Affiliate Fitness Store page.