Affiliate Registration

Would you like to be part of our Affiliate Program? Great, you are extremely important to us! Together, we are able to spread the message that the foundation of a healthy life starts with what you eat. To learn more about the affiliate program, please fill out the form below.

Customer
Affiliate

First Name

Last Name

Username

Password

Confirm Password

Business Name

Website URL

Address

City

State/Province/Region

Zip / Postal Code

Country

Paypal Email (We'll use this to pay out commissions!)

Instagram Handle

Facebook Profile Link

Why would you like to be an Adapt Affiliate?

Do you agree to our Terms of Use?

Are you familiar with Dr. Eric Westman?

ARE YOU FAMILIAR WITH ADAPT PRODUCTS?

PLEASE NOTE: WE DO NOT ACCEPT PRODUCT REVIEW SITES, COUPON CODE SITES OR AFFILIATED LINKS TO ACT AS AN ADAPT AFFILIATE.

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AFFILIATE REGISTRATION