Affiliate Registration

If you are human, leave this field blank.

POLICIES

Terms & Conditions

I have read and understood the information provided on the Affiliate Referral Program web page and I agree with all the terms and conditions outlined on that page.

Spam

I provide express consent to PT EXAM PREP to communicate with me using the email address I provide in my application. This includes future student information updates, announcements, event/seminar invitations, surveys, contests and other notifications. This also includes the sharing and exchanging of any personal information I provide in the application, as defined in the Privacy Policy.

Paypal

I have a Paypal account, or I agree that I will create one in order to receive referral fee payments.

AFFILIATE INFORMATION

First & Last Name

Address

City

Province/State

Country

Postal Code/Zip Code

Email Address

Confirm Email Address

Primary Phone

My Promotion Code:

Link to the Website(s) you will place the affiliate link on:

Are you a physiotherapy clinic owner?

Yes

No

If you said "yes" to being a clinic owner above, please provide us with a 200 word description of who you are.

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