Wufoo

[MINARINSHOP] Affiliate Application Form

Fill out this form if you are interested in becoming affiliates and swapping banners. Please fill it out in its entirety. Thank you!

Name * First Last
Please enter your full name. This does not have to be your real name, just the name that is listed on your website.
Store/Seller Name *

Please enter the name of your store/service.
E-mail address *

Please enter a valid e-mail address. This can be your personal address or your store address.
Website URL *

Please enter the full URL of your website.
Type of website *

Select the category your website is best defined as.
How did you hear about MinarinShop?
Google GarageSaleJapan/Videogames4Sale Your personal LiveJournal

Please select how you discovered MinarinShop.
Description of your Shop

Please enter a brief description of your site. I may add on to this, but it'd be good to have an idea of your shop. You can enter anything that represents your shop. For example, "[name of shop] offers plushies, anime goods, other goodies at a discounted price!".
Banner *

Please enter a link to your banner or any image used to represent your site. I may ask you to re-size it, but look at this one as an example.
Notes

Please enter any other information here.
Do Not Fill This Out