Become an Affiliate Want to know more? Sign up to be an Affiliate for Tech Minded. Simply fill out the form below, and we'll get you more information. This field is hidden when viewing the formAssoc IDThis is an internally used ID. It won't be known by the user, and needs to be filled in post-contract, before creating the user.Name* First Last Company/Organization NameTitleWhat is your title?Username*What would you like your login name to be?Email* Are you looking to become a Tech Minded Affiliate?To speed the process along, by checking "Yes", you are requesting we reach out to you to answer any questions, as well as to create an Affiliate agreement (for which you have no obligations to until you sign). The information that you provide below will allow us to quickly generate an Affiliate agreement for you to digitally sign. This agreement gives us the ability for you to point potential clients to Tech Minded and be rewarded if they end up sign up for services. Yes No Member TypeThis is the type of Tech Minded member you are requesting to be.AffiliateInformation We Need to ProceedAddress* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone: WorkPhone: MobilePhone: Main OfficePhone: FaxWebsite Help Us Know YouThe next few questions help us to know a bit about you and what you do -- it speeds the process along.How would you (Choose all that apply)* We are a non-profit. We are an association. We are a Chamber of Commerce. I am an individual wanting to be an affiliate. We are a business wanting to be an affiliate. This field is hidden when viewing the formWhat type of people are your members/followers/clients? Business Non-Profit Schools / EDU Government Churches, Synagogues, Mosques, etc... Other Additional NotesSocial Media for You/Your Organization What is your organization's twitter account?What is your organization's Facebook account?What is your organization's LinkedIn page?What is your organization's Instagram page?CAPTCHA
