Full Name *

Preferred Name

Email *

Phone *

Address *

Mailing Address

City

State

Country

Postal Code

Date of birth *

Instagram Handle (If you do not have any of these social media profiles please put N/A) *

TikTok Handle *

Facebook Profile URL *

LinkedIn URL *

How did you hear about the E-Athlete? *

Did you watch the entire E-Athlete Reel? If so, what would you say the E-Athlete/The E-Athlete Experience is? *

In your own words, what is an E-Athlete Advocate, and why are you interested in becoming one? *

Have you ever sold or promoted a product or cause before? (If Yes please add brief description) *

What does Capabilities Over Disabilities mean to you? *

By checking this box, I understand that as an E-Athlete Advocate:

I will share the message of The E-Athlete with love, integrity, and authenticity.
I will earn a 50% commission on contributions and 25% commission on sales made through my unique EAAD code/link.
I will submit my weekly report by Sunday at 7:59pm EST to receive payment each following Friday.
I will uphold The E-Athlete values of empowerment, inclusion, and positive energy to the best of my ability

By checking this box, I consent to receive transactional, marketing, and promotional messages related to my account, orders, services I have requested, special offers, discounts, new product updates, appointment reminders, order confirmations, and account notifications among others. Message frequency may vary. Message & Data rates may apply. Reply HELP for help or STOP to opt-out.

Digital Signature *

Clear

Date

EAAD (ADMIN USE ONLY)

Code:

Assigned By:

Start Date:

Notes/Status:

Active / Inactive / Pending