Affiliate Sign Up Form

Thank you for your interest in becoming an Affiliate of Jen Mons Coaching Healthy Lifestyle Programs.  Please allow 5-7 business days to review your request.

Your Full Name *

Your Email *

Phone number *

Do you have a paypal account?

Email for paypal payments (if different from above):

Desired username *

For your affiliate account and referral url. For example, if your username is "dtintructor" your referral url would be ""

What is your current role in fitness/health/nutrition?

What certifications do you currently hold?

Which affiliate program are you interested in? *
Dance Trance FitnessHealth/Yoga/Fitness

Dance Trance Studio Location (if applicable):

Do you have a nutrition program currently in place at your studio?

Please list your website here if you have one:

Message/Comments (optional):

I Agree with Terms of Agreement *