Referral Partner Sign-Up for Prosperity Accelerator

Referral Partner Registration

When you sign up to be a referral partner, you'll get links, banners and other images you can use on your website that will help you promote us!

Simply fill out this web form we will setup your account!

Part 1 - Contact Information

First Name *
Last Name *

Company

Cell Phone *

Email *

Part 2 - Your Address

Part 3 - Referral Partner Registration

Affiliate SSN/TAX ID *

We required your SSN/TIN for proper tax documentation

Your referral payment will be sent to you via echeck to the email address provided.

Please create your affiliate username and password (so that you can login to the affiliate dashboard)

Username *

Password *

Confirm Password *

Notify on Lead

YesNo

Notify on Sale

YesNo