NOTE: PRINT A COPY OF THIS ENROLLMENT FORM FOR YOUR RECORDS BEFORE SUBMITTING IT.

If this form is not functioning properly, Call (940) 464-3141

ENROLL IN THE CHURCH BUSINESS NETWORK AS AN

AFFILIATE
Please describe your position in the Affiliate Company
Owner
President or CEO
Affiliate Program Agent
Business Manager
Partner
Other (describe below:)t

Complete the Following Information about and Your Company:
(ALL Fields MUST be completed to be a Member):
Sponsoring Agent / ID# Type both Name & ID # of CBN Agent enrolling You (if any)
Your Name This name will be considered the Authorized Contact Person
Company Name Must be a Legal, Non-Profit with the IRS to receive donations available thru CBN
Mailing Address
City
State
Zip Code
Phone Number
(Digits only)
Email Address Add Me to Your "CBN Weekly ENewsletter" List
Company Website URL

How would you prefer that CBN be paid for Selling Your Products/Services:

Example: Discount from Retail / % of Total Gross Sales / Other...

Name of Person who will Authorize and Maintain Your relationship with CBN. This is REQUIRED to become a Affiliate
Phone Number of Authorizing Person
Additional Comments or Questions:


What TOP 10 Products or Services will your company be selling through CBN?
  Check here if your company wants to participant in PHASE 3: One Shopping Cart - One Bill (This will require a list of products (SKU's) be submitted to our database when requested)
Product/Service
Product/Service
Product/Service
Product/Service
Product/Service
Product/Service
Product/Service
Product/Service
Product/Service
Product/Service
COMPLETE ENROLLMENT BY CLICKING HERE:

Copyright 2008 - The Church Business Network • P.O. Box 996 • Argyle, TX 76226 • (940) 464-3447