Partnership Program Application

Contact Information

        Thank you for considering to be a partner with Heinsohn's Country Store. We believe that we have a unique website with very unique products.    If you send a customer to our website and they purchase something, we will be glad to pay you 10% on all items up to $100 and 5% on those items above $100.
        If you are interested, please fill out the following form. This is the information used in all correspondence about your participation in the Partnership Program.

Note : You must enter a password to protect your account and you must enter the admin contact email address so that we can contact you if required.

* Required Field
* Company Name:
* First Name:
* Last Name:
* Street Address:
* City:
* State/Province:
* Postal Code:
* Country:
* Phone:
* Email:
  Confirm Email:
  Please double check your email address in the above field, as this is where we will be sending you all of your information.

  Tax ID:
* Password:
  Password (confirm):
  If you will be promoting our items from your website, please fill out the information below.
  Website URL:
  Website Title:

  Website Description:

You will be contacted within 5 minutes by email with your special assigned URL and easy instructions on how to get everything set up immediately. There is an approval process before you can be completely activated. Links to our page must be in the same clean enviornment as our website. Our ethics must be beyond reproach.

Heinsohn's Country Store      financing available!
In Our Family since 1920
For Old Time Country Values!
Se Hablá Español

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