Affiliate InformationAlready registered? Login here.THE ACCOUNTName* First Last Company name*Brand name*Phone*Website* Address* Street Address Address Line 2 City StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Account email* Enter Email Confirm Email We contact you at this email. You will also use it to log in.Account password* Enter Password Confirm Password Strength indicator Affiliate manager's full nameAffiliate manager's phoneAffiliate manager's emailAS AN AFFILIATEMy personalized promo code*Use letters and numbers only. No spaces. This is the promo code your followers will use during checkout.My personalized landing page URL extension*We create a personalized landing page for you to share with your followers.Upload your logo*Max. file size: 100 MB.For your personalized landing page.Upload your headshot*Max. file size: 100 MB.For your personalized landing page.Upload a fun photo of youMax. file size: 100 MB.We add two photos to your personalized landing page. If you don't have another one, it's fine.PROMOTIONSAre you able to drive at least 1000 leads to our sales funnel during your first promotion?* Yes No We will provide you with a complete well-converting sales funnel for you to drive your traffic to.Total list size (60-day actives)?*What is your next ideal promotion date?Month123456789101112Day12345678910111213141516171819202122232425262728293031Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920How will you promote us?*GETTING PAIDPayPal account email We pay commissions via PayPal. It is fast, free, and easy! However, if you prefer a different method, please email us after you have completed this form at affiliates@organixbed.com.Upload your W-9 form*Max. file size: 100 MB.Uploaded files receive encryption and are secured.Download a W-9 form here (this link opens a new tab)CONCLUSIONTerms & Conditions and Privacy Policy* I agree The information submitted through this form is encrypted and secure. Please see our Terms & Conditions for terms related to our affiliate program. Your personal data will be used to support your experience throughout this website, to manage access to your account, and for other purposes described in our privacy policyΔ