Affiliate Program Application

Name	Phone nnn-nnn-nnnn	Fax nnn-nnn-nnnn
Company	Email
Mailing Address	Payment Address
Site Description	Site URL
Enter Text Below:
By applying, you certify that you have read, understand, and accept the terms of the Affiliate Program Agreement.

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Instructions

Please enter your contact information, your mailing address, and the address where commission payments will be sent to.

Describe the web-site or newsletter where you will be placing your affiliate link to Endicia and/or PictureItPostage. Indicate the industry it serves and the size of its customer-base. Include your web-site's URL.

Once you have reviewed the Affiliate Program Agreement, submit this form, and we will contact you with your affiliate link.

Program Contact

Endicia
247 High Street
Palo Alto CA 94301-1041

(800) 576-3279 x140
(650) 321-0356 fax

affiliates@endicia.com