Ambassador Program
Email address *
First Name *
Your answer
Last Name *
Your answer
If you have a blog, please copy and paste the link to your homepage below (EX. www.blogtitle.com), if you do not have a blog, please leave this question blank.
Your answer
Your Instagram Handle WITHOUT the @ sign (EX roxjewelryshop NOT @roxjewelryshop) *
Your answer
How many followers do you currently have on Instagram for the above username? (This is used to validate your account and determine initial ambassador discounts) *
City
Your answer
Country *
Your answer
Phone Number (use no dashes or spaces)
Your answer
Are you okay with us texting you? (We won't spam you!)
What would you like your discount code to be named? For example, "MilliROX". Your discount code will be the code that you insert here. Please take note of it. It is a 15% discount code. ***To minimize the risk of duplicate codes or customer confusion, we recommend choosing a unique code with no spaces*** *
Your answer
Birthday
MM
/
DD
/
YYYY
How many posts of our product(s) do you plan on making? (if ordering, must be within 30 days of receiving item) *
Do you plan on posting your own pictures (with a product you bought from our site) or posting our pictures? *
What is/are your favorite item(s) on our site? *
Your answer
How would you like us to pay you? *
Please enter the details of your payment information below. For example, if you selected Paypal, list your associated PayPal email. If you opted for Venmo, list your Venmo username. If you opted for store credit put n/a *
Your answer
I have read fully, and accept the Terms and Conditions as outlined at the link at the beginning of this page that says "Ambassador Program Terms and Conditions" *
Required
We value your opinion! Would you mind filling out a brief survey to help us improve our business? *
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