1.800.862.5965  •  May 20, 2012
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Cyberlynk Alliance - Partner Signup

Alliance Partner Signup/Application

Application for participation in CyberLynk's Referral program and a listing in our Alliance Parnter directory can be done by completing the information below.

Your application will be processed upon submission and confirmation in our Alliance and Referral programs will be sent to you via the E-mail address supplied.

Those items marked with * are required items.

Those items marked with * will be displayed in your listing on-line.


Your E-mail address will be used as your login to gain access to our Partner System. Please provide a valid address - one that you check regularly. Your password can be anything - please write this down.

Email:
*
Password: *
Verify Password: *

Please provide your real name. If you are signing up as the representative for your company, please include your title.

Name: *
Title:

Please provide company information. If you are applying as an individual, please provide personal information. This information will be used to forward referral bonuses and printed literature.

Company: *
Address1: * *
Address2: *
City: * *
State: * *
Zip: * *
Phone: * *
Fax: *
Alt Phone:

Please select a the definition that best describes what your company does. If you are applying as an individual, what best describes what you do.

Type: *

Where can we find your web site or web page? This information will be presented to those looking at our partner list.

URL: http:// *

Please include a written description of what your company does or what you do. This will be presented to viewers of our Alliance area. HTML code can be included here.

Business Description: *

Describe your typical customer - who do you normally service or sell services to?

Typical Customers: *

If there is information that you wish to convey to CyberLynk that you do not wish to show up in your listing, enter it here.

Comments:

Do you want to receive special mailings to our Alliance partners regarding new services and special pricing or promotions?

List: Yes No

Do you want your information to appear in our list in the Alliance Partner section of our web site?

Show: Yes No

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