Mike Holt Affiliate Program Registration

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To qualify for our affiliate program you must be a business that provides resources, education, products and more to the electrical industry.

Please answer the following questions:

Who is the target audience for your website?
Please describe your company.
Please complete the following to apply for your affiliate account
Name
Title
Company Name (Checks are made out to this name)
Address
City
State/Provence
Zip Code
Phone ( ) -
Email
Web Site http://
Example  www.yoursitename.com
EIN [ Employer Identification Number ] (Required for Payment)
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