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Please input your information in the fields on this page.
'Desired Coupon Code' is a name of the coupon you are planning to give out to your followers or friends. So, for example, if you are running a blog called Nootropic Brain, something like 'NOOBRAIN' or just 'BRAIN' might be a good choice. Please do not use this field to tell us what share of the sales you want to receive as an affiliate.
If you are part of the company, please specify which company you are representing
Please name at least one place where you are planning to promote Cosmicnootropic
If you want to share any other details about yourself or your followers, please use Comments field.
We will contact you shortly after you have submitted your application. If email is not convenient for you, please leave your preferred communication method in the comments field. If you have any questions, before applying, please email us at email@example.com