Affiliate Program Application

This is the Affiliate Application for receiving commissions for selling Lisa M Pepe’s Well-Weight-Wisdom Programs.
Please fill out the Application below and allow up to 5 business days for a response.
We will do our best to get back to you as soon as possible.
If you have not heard from us after 5 business days, please reach out to us on the CONTACT page of this website.
Thank you for your interest in sharing my programs with others!

Please Fill in The Following and Submit:

15 + 12 =

 Form Fill Instructions:

 Please fill in your first and last name

 Your Social Security Number or Employer Identification Number is Required for Tax purposes.  You can opt to give this on the W-9 form once your Application is accepted.

Two E-Mails are required if your contact address is different from your PayPal E-Mail Address.  A PayPal account and E-Mail address is required for payment.

Fill in your best contact phone #

Fill in your complete mailing address

Become a Lisa M Pepe Well-Weight-Wisdom Affiliate

A Company name is not required but if you have one,
please put it on the form

A Website Address is also not required,
but please put if you have one

Please list the ways in which you plan to sell the programs.
On a Website
By E-Mail
Social Media Posts
A Blog
On-Line Advertising
In Person

Tell me a little about yourself, your company and why you are interested in selling my programs.  All additional comments or questions can go here as well.  Thank You again for applying!

By submitting this form, you agree to the Affiliate Program Terms

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