NOTARY ROTARY
®
AUTHORIZED AFFILIATE PROGRAM (NRAAP)
Please complete this form if you would like to join the Notary Rotary Authorized Affiliate Program (NRAAP).
Version 1.2
N R A A P A P P L I C A T I O N
Company / Partner Prospect Information
Company Name
Contact Name
Web Site
E-mail Address
Physical Address
Street Address:
Street Address 2:
City: State: ZIP:
Mailing Address
Street Address: Same as above [ ]
Street Address 2:
City: State: ZIP:
Phone
Fax
EIN
Do You Have a Notary
Rotary Account?
[ ] No [ ] Yes, my user name is:
Are You an Approved
Educational Vendor?
[ ] No [ ] Yes
Are You a Licensed
Insurance Agent?
[ ] No [ ] Yes, my license number is:
Which Program Options are You Interested In?
Retailer / Vendor Eligibility ONLY Open Eligibility
[ ] Option 1 - Notary Supply Kits [ ] Option 3 - Discount Letters
[ ] Option 2 - Volume Purchase [ ] Option 4 - Fulfillment
[ ] Option 5 - Affiliate Link
Briefly Describe Your Marketing Plan for Notary Rotary Products:
By signing below, I am requesting to participate in the Notary Rotary Authorized Affiliate Program.
If accepted, I agree to all terms and conditions detailed in the NRAAP Agreement.
____________________________________________________________________________
Authorized Signature / Title or Capacity Date
PLEASE FAX THIS COMPLETED FORM TO NOTARY ROTARY AT 877-349-6590
OR E-MAIL TO PARTNERS@NOTARYROTARY.COM
