Affiliate Sign Up - Rhoose Point Remedies

Affiliate Sign Up Form

Name *

First

Last

You Instagram handle / username *

No of Instagram Followers

Email *

Your profession *

Are you happy with the suggested customer discount code we sent to you in your welcome pack? *

If you wish to change the suggested customer discount code, please let us know what you wish to change it to below:

Please only use a code that will have between 3-5 letters include. We will add "10" on the end of every code. For example "RPR10"

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Paypal Email Address

This is so that we can send you any commission you have earned

Are you VAT Registered?

Are you happy for us to email you monthly to let you know your commission total? *