Whole Child Counseling's Affiliate Program Application
Sign in to Google to save your progress. Learn more
Thank you so much for your interest in being a member of Whole Child Counseling's Affiliate Program. 

Please complete this form to provide information for consideration.  If you are accepted as an affiliate, you will be notified within 4 weeks.

If you have questions, you can reach me here.
Your First & Last Name *
Email Address (for me to contact you)
 *
What is your occupation and/or role(s) in the education, parenting, or mental health fields?
 *
What makes you a good fit for being a Whole Child Counseling affiliate? 
 *
What Whole Child Counseling resources do you currently have and use?
 *
Which platform(s) will you promote Whole Child Counseling's resources? *
Required
Do you have access to a color prionter? *
Required
Please leave a link to your blog and/or social media pages. *
Leave your Paypal email address for payment:
By submitting this application, you are agreeing to the TERMS & CONDITIONS of the Whole Child Counseling Affiliate Program.  

 *
Type your first and last name to verify that you've read and agree to the terms and conditions.
 *
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms