Affiliate Set Up - Powered by Keap

To signup for our Affiliate program, please fill out the form below:

IMPORTANT: You MUST be an existing customer of THCG to sign up as an affiliate.

First Name *

Last Name *

Email *

Street Address 1 *
Street Address 2
City *
State *
Postal Code *
Country *

Phone *

Who, if anyone, referred you to our affiliate program?

We pay affiliates via PayPal. Please enter your PayPal email address below:

PayPal Email Address *

Below, enter the username and password you would like to use to login to our affiliate center:

Username *

Password *

Confirm Password *

By completing the form, you agree to the terms and conditions of our affiliate program here: https://thehealthcoachgroup.com/affiliate-program-terms-conditions/ *