Brand Application Form

Brand Form For Partner

Before you begin

We’ll ask for a few key details to understand your background and fit. The form takes around 30–60 seconds to complete.

Brand Application

1. Brand Overview

Company Name

Website URL

Primary Contact Name

Email address

Monthly Revenue Range

Under $100K $100K to $500K $500K to $1M $1M to $5M $5M+

Primary Product Category

Supplements

Biohacking / Devices

Functional Beverages

Mental Health / Focus

Detox

Fitness

Other

Brand Application

2. Current Affiliate Setup

Do you currently have an affiliate program?

Yes No

What platform do you use?

Standard affiliate commission %

Highest commission offered %

Do you offer lifetime commissions?

Yes No

Primary affiliate coupon code discount offer details

Brand Application

3. Performance & Alignment

Top converting landing page URL

Average Order Value

Conversion Rate

Ecommerce Platform

Shopify

Shopify Plus

WooCommerce

Custom

Other

Why do you want to join the Affiliate Health Network?

Are you prepared to run a performance based rev share model with no retainers?

Yes Need more info

I understand AHN is a curated network and not all brands are accepted