Affiliate Program Application Apply to become an affiliate. HiddenNext Steps: Sync an Email Add-OnTo get the most out of your form, we suggest that you sync this form with an email add-on. To learn more about your email add-on options, visit the following page (https://www.gravityforms.com/the-8-best-email-plugins-for-wordpress-in-2020/). Important: Delete this tip before you publish the form.About YouYour Name(Required) First Last Business name Your Address Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Country How Can We Reach You?Preferred Method of ContactEmailPhoneYour Email Address(Required) Email Address Confirm Email Address Your Phone(Required)Website Address A Little About YouHelp us learn more about you and why you would be a good fit with the TFHKA Affiliate Program.What connects you to TFHKA?(Required)Why are you interested in the Affiliate Program?(Required)What modality do you practice regularly?(Required)How do you bring benefit to the TFHKA and it's members?(Required)Do you have credentials to teach TFHKA classes?(Required) Yes No Are you seeing clients?(Required) Yes No Are you a member of TFHKA?(Required) Yes No Are you in direct competition with TFHKA?(Required) Yes No View Terms and ConditionsDo you agree to the terms and conditions of the Affiliate Program?(Required) Yes No CAPTCHA Δ
