Partner Program Application

You're one step away from joining our money making program! Just complete the form below and we'll contact you soon with the exciting details. The information requested on this form is for 8minuteDating.com's internal use only and will not be shared with any other companies or individuals.
Contact Information
Company		Job Title
First Name		Last Name
Address		Address (cont.)
City		State/Province
Zip/Postal Code		Country
Phone		Email
Fax
Website Information Please include a short description of the website where you will promote 8minuteDating.com. This will inform us of the nature of your business.
Web Address
Description
Account Information Login and Password must have 4-20 characters
User ID
Password		Retype Password