January 19, 2011
8:30 PM - 10:30 PM
Miami, FL, USA
Monty's Bar & Grill
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PARTY WITH OTHER AFFILIATES!

Go to Affiliate Convention Party 2011 FOR FREE!

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* Select Event:
* First Name:
* Last Name:
* Website:
Title/Position:
Company:
* Address:
 
* City:
State:
* Zip Code/Postal Code:
* Country:
* E-Mail:
* Telephone:
Fax:
* Which best describes your business?
(Check all that apply)
 Affiliate
 Network
 Merchant
 Affiliate Manager
 Agency
 Payment Processor
 Other (Please Describe)
* What Industries are you currently promoting or plan to promote in the next 12 months?
(Check all that apply)
 Adult
 Antiques / Art / Collectibles
 Automotive / Boat
 Baby / Children
 Business & Industrial
 Books
 Clothing
 Dating
 Diet, Health & Beauty
 Electronics
 Entertainment / Movies / Music
 Financial / Banking / Real Estate
 Games (non-gambling)
 Gambling/Casino
 Gift Certificates
 Home & Garden
 Insurance
 Jewelry / Watches
 Medical / Pharmaceutical
 Mobile / Telecom
 Software
 Sporting Goods & Memorabilia
 Technical
 Tickets / Events
 Toys & Hobbies
 Travel
* What Regions of the World are you currently promoting to or plan to promote in the next 12 months?
(Check all that apply)
 North America
 South America
 Europe
 Eastern Europe (incl. Russia)
 Asia
 Mid East / Africa
* What languages are you currently promoting to or plan to promote in the next 12 months?
(Check all that apply)
 English
 Spanish
 German
 French
 Italian
 Swedish / Norweigan
 Russian
 Other European
 Japanese
 Mandarin / Cantonese
 Korean
 Other Asian
 Other
* What forums are you a member of?
(Check all that apply)
 ABW
 WickedFire
 5 Star
 Not a Forum Member
* Please advise your primary methods of promotion as an affiliate
(Check all that apply)
 Pay Per Click
 Search Engine Optimization
 Email marketing
 Offline Marketing
 Coupons
 Blogs / Content
 Rebate sites
 Shopping portal
 Social / Viral marketing
 Loyalty / Member sites
 Other (Please Describe)
How did you hear of this event?
  If you were referred by someone (or a web site), please enter the name below:

Comments: Please list any comments or requests you have for the affiliate program. You can list other websites you have here as well as why you think the affiliate program should sponsor you. (Informing the affiliate program about yourself will increase your chances of being selected)

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