Mermaid Purse Program Registration

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Completing this form is the first step to becoming a Mermaid Purse Program Affiliate. Next steps include 1) signing terms and conditions, 2a) providing tax and 2b) banking info for payments, 4) receiving promo materials for display and use in your business.

Email *

Affiliate Full Name *

Business Name (if individual, leave blank)

Phone number *

Address *

Affiliate program type *

Business Purse (signed terms, tax info and bank deposit info required for payment )

How did you hear about the Mermaid Purse Program? *

Instructor Halie

Steve Smith

Mermaid Dawn (Goo)

Adventure Mermaid website

Adventure Mermaid blog

Other

A copy of your responses will be emailed to the address you provided.

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