Xero Shoes Affiliate Application

To become a Xero Shoes Affiliate, fill out the form below. Items with * are required.

Your Information:

Email Address:*

First Name:*

Last Name:*

Affiliate ID:*

(Create an ID to be part of your Affiliate URL... e.g. www.XeroShoes.com/go/Affiliate_ID)

Website URL:

(If you have one)

Company Name:

Street Address:*

City:*

State/Province:*

Country:

Zip/Postal Code:

Phone Number:

How will you Promote Xero Shoes?

Payout Method:

PayPal Email Address:*

SSN:*

(We need this to be able to pay you. Non-US Affiliates, type "N/A")

I have read and agree with the Terms & Conditions