Application Form for Private Nutra COD Affiliate Network

*1. Your media buy team size or are you from ad network ?

a.I am an individual mediabuyer.

b.A mediabuy team of less than 5 members

c. A mediabuy team of 5 members or more

d. A I am from ad network

*2. How long have you been in this business?

a. Less than 1 year

b. 1 to 3 years

c. More than 3 years

*3. Your main traffic sources are:

a. Facebook

b. Google

c. Native

d. Push

e. Others please specify

*4. Your top verticals are:

a. Nutra

b. COD

c. Sweepstakes

d. Dating

e. Others please specify*

*5. Your top GEOs are:

a. Global

b. South-East Asia

c. Amecian and European countries

d. Others please specify*

*6. Your average daily revenue amount is about ?

a. Less than $1000

b. $1000 to $3000

c. $3000 to $5000

d. $5000 to $10000

e. More than $10000

*7. Please leave your contact information so that we could contact you in time:

*

Your Email *

Your Name

Company Name

Phone number