Affiliate Application Question Title * 1. Please provide us with your contact information. Name Address Address 2 City/Town State/Province ZIP/Postal Code Country Email Address Phone Number Question Title * 2. Have you completed Erica's Prenatal Exercise Specialist Instructor Certification? Yes No Currently In Progress Question Title * 3. Which of Erica's programs have you have joined or purchased? Please select all that apply. Knocked-Up Fitness Monthly Membership Core Rehab (Entire Lifetime or Monthly Membership) Core Nutrition Program Knocked Up Fitness Guide To Pregnancy Book Prenatal DVDs One-on-one training/coaching sessions with Erica None Other (please specify) Question Title * 4. Why do you want to be an affiliate for Erica Ziel? Question Title * 5. What is one way in which you feel you could help promote one or more of Erica's programs or products? Question Title * 6. Please tell us a little bit about you and anything else you would like us to know! Next
