Bennet MarineAffiliate Application

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Please submit the following information to join our Affiliate Program.

Fields In RED Are Required

Site Information

Site Name:
URL of Site:
Briefly describe your site:
Your Website Category:	Boating
	Sailing Cruising Fishing GPS Diving Outdoors Watersports Other

Mailing Address

Address 1:
Address 2:
Address 3:
City:
State:
Province:
Postal Code:
Country:
Phone:
Fax:

Primary Contact

Payee Name:
(Enter the payee name for the individual or company to whom we should make checks payable.)
Title:
E-Mail:
Taxpayer ID Number:
(Required of all U.S. residents. The number you provide must correspond to the payee you have identified above. For individuals, this number is your Social Security Number (SSN). For other entities, it is your Employer Identification Number (EIN).)

Check here to indicate that you have read and agree to the terms of the Affiliate Agreement. I understand and agree to the terms.

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