AFFILIATE REGISTRATION

Innovative CEUs, LLC
61 N. Plains Industrial Road, PMB 387
Wallingford, CT 06492
877-817-0230

Registration is a 3 step process.
AFFILIATE INFORMATION -- VERIFICATION -- MARKETING METHODS

After being approved by the Affiliate Manager, your login credentials will be emailed to you.
AFFILIATE INFORMATION
* FIRST NAME
* LAST NAME
* EMAIL
 
COMPANY
* COUNTRY
* ADDRESS
ADDRESS 2
* CITY
* STATE
* ZIP
* HOW DID YOU FIND US
* CONTACT INFORMATION
* At least 1 phone number is required. (The one checked as primary)
Check the radio button to indicate which number is your primary number.
HOME PHONE (primary) - -
OFFICE PHONE (primary) - - Ext.
CELL PHONE (primary) - -
FAX - -
I have read and accept the Terms & Conditions
I have read the Site Disclaimer Policy
I have read the Privacy Policy