Referrer Application Form

You can profit from sending us customers. All you need to do is sign up, then place a special link on your Web site. Users who click the link on your web site will be noted as referred by you, and you will earn a 10% commission on their purchase total--automatically.

Sign up with the form below. You must complete this entire form and read and agree to the Piano Fun Referrer Service Agreement

Person Information
First Name *
Last Name *
Email *
Phone 1 *
Street Address 1 *
Street Address 2
City *
State *
Postal Code *
Options
Terms of Service:	I have read and agree to the terms of service
Affiliate Signup Information
Username *
Password *
Retype Password *
Notify On Sale	Yes No
Notify On Lead	Yes No