Application

FIRST NAME:

LAST NAME:

STREET ADDRESS:

CITY:

STATE:

ZIP CODE:

DO YOU CURRENTLY OWN A BUSINESS?

IF SO, WHAT TYPE OF BUSINESS?

OCCUPATION:

DATE OF BIRTH:

MARRITAL STATUS:

CELL PHONE:

HOME PHONE:

EMAIL:

The primary mission for an Affiliate is to market the Liberty Water brand products online and in person.  An Affiliate will get compensated for online sales in their zip codes and they can buy products wholesale and mark up to fit the local demand.  To gain an understanding of your background please answer the following questions.

MARKETING EXPERIENCE:

SOCIAL MEDIA ACCOUNTS

FACEBOOK:

NUMBER OF FOLLOWERS:

YOUTUBE:

NUMBER OF SUBSCRIBERS:

INSTAGRAM:

NUMBER OF FOLLOWERS:

TELEGRAM:

NUMBER OF FOLLOWERS:

MeWe:

NUMBER OF FOLLOWERS:

OTHERS:

ASSOCIATIONS

VFM:

AMERICAN LEGION:

DAUGHTERS OF THE REVOLUTION:

VIETNAM VETERANS OF AMERICA:

SHRINERS:

OTHERS:

Are you interested in

Online sales:

Wholesale sales:

Both: