Affiliate Registration "*" indicates required fields Name*Tell us who you are First Last Affiliate Sponsor*How did you hear about our Affiliate Program? Please select their name from the list below.Ben J MarinoBernard MarinoJeanette MarinoMike HillKeith FreemanRoland GilfourMallery ChiassonAllen CambronGriffin GoreWally RakestrawMatt HochstrasserGabriel GonzalezHaley Kristen ByarsHaley Morvant/AyoTEAM Media Affiliate SupportMaxwell MarinoMichelle Sztraky - AffiliateMelissa WelchBenny MarinoMakaela Benoitbrooklyn hudspeathTodd AshleyCorbec MediaMichael BlankenshipCourtney KattengellLandon ThompsonJason GilfourBayou MarketplaceThomas AshyDon McCoyNicol MontivilleBlain WagnerMerritt LemoineTiffany LoftonThis field is hidden when viewing the formAffiliate Sponsor IDEmail*This will be your affiliate username. *NOTE: Your password to the site and our mobile apps will be emailed to this email address once you submit the form. Please note you can change your password upon next login if you'd like, but we strongly recommend setting up the 2 factor authentication to protect your account. Enter Email Confirm Email Mobile Phone*Please input your Mobile Phone #Password*PLEASE NOTE: This will be your TEAM Affiliate Account password. Enter Password Confirm Password Strength indicator PayPal Email*Please provide your PayPal email address. This is the email address we will use to payout your commissions to. If you do not have a paypal account, please create one as we will not be able to provide payouts using any other form of payment at this time. Enter Email Confirm Email Address* Street Address Address Line 2 City State ZIP Code Desired Region*Tell us which areas you would like to operate in. It's ok if your region is not listed, just choose one and let us know after you sign up where you would like to operate and we'll add. Katy, TX - Cinco Ranch WestKaty, TX - Old KatyHouston, TX - HeightsHouston, TX - MontroseHouston, TX - DowntownNew Orleans, LA - UptownNew Orleans, LA - Warehouse/CBDNew Orleans, LA - French QuarterNew Orleans, LA - MarignyNew Orleans, LA - BywaterNew Orleans, LA - Lakeview/LakeshoreNew Orleans, LA - MetairieNew Orleans, LA - KennerNew Orleans, LA - GretnaNew Orleans, LA - EastClear Lake, TXGalveston, TXKaty, TX - Bella TerraNew Orleans, LA - WestbankThibodaux, LAHouma, LAHouston, TX - WestMy Photo*Please take a picture of yourself for your profile Drop files here or Select files Accepted file types: jpg, jpeg, gif, png, pdf, Max. file size: 20 MB, Max. files: 1. Installation*Would you be comfortable and able to install the Host Billboard Unit at a Host Sponsor Location? If not, not to worry as we can facilitate this for you. If you are able to perform a professional installation, we will provide you with an additional commission for your time and effort. PLEASE NOTE: Installations, in many cases will require: 1. The ability to lift objects over 50lbs. 2. The use of a ladder over 4ft tall. 3. Possession of and delivery to/from a host site with appropriate tools, ladder and other equipment to complete installation professionally 4. In some cases, electrical adjustments will be required. Affiliates without proper licensing and/or certification are prohibited from making electrical modifications. 5. TEAM Media Group LLC is not liable for any damages to the Host location. 6. Affiliate agrees by checking Yes, that such Affiliate assumes any and all risk associated with the installation process including, but not limited to damages, personal injury of an Affiliate or any other 3rd party. Yes No Terms & ConditionsPlease read and acknowledge belowWorking Agreement: 1. TEAM Media Group LLC (Company) enters this agreement with Contractor signing this agreement the understanding that you will be a contractor and not a direct employee of the Company. 2. The Company provides tools and solutions to help you succeed in the business model designed for its contractors and such tools should only be used to perform the duties of this working agreement. 3. Contractor will return any and all Company property back to Company immediately following termination of services. 4. Contractor will abide by any and all state and federal laws during performance of this working agreement. 5. Contractor agrees to read and sign rules or policies delivered at any time to them in the future in order to continue this working agreement. 6. Contractor agrees to maintain in strict confidence and agree not to disclose except as authorized by the Company, any information of a competitively sensitive nature that he/she receives from the Company or its Clients in connection with the working agreement. 7. The confidentiality agreement terms in line 6 will continue for a period of 12 months post termination or voluntary leave from the Company by Contractor. 8. Contractor will not compete with the Company during the working agreement and for a term of 12 months post termination. 9. Contractor agrees during the working agreement and for a period of 12 months post termination, he/she will not knowingly solicit, entice, or persuade any Company employee or Contractor to leave the services of the Company for any reason. Do you have a valid Drivers License?* Yes No Drivers License*Please upload or take a photo of your drivers license. Feel free to upload front and back. Drop files here or Select files Accepted file types: jpg, gif, jpeg, png, pdf, Max. file size: 20 MB, Max. files: 2. Please acknowledge you are in agreement with the terms above:* I have read, understand and agree to the Terms & Conditions above I understand I am a contractor and not an employee of TEAM Media Group LLC I will be respectful, courteous, professional and honest with the Hosts and clients of TEAM Media Group LLC I understand the TEAM Media Group LLC Commission Structure and Policy will be provided once I am approved as a TEAM Member I agree to follow all policies and procedures of TEAM Media Group LLC I agree to provide a high quality service to clients of TEAM Media Group LLC I acknowledge that signing this form electronically is considered a legal agreement Select AllSignatureName*Print your Name Below First Last Consent* I agree to the privacy policy.Date* MM slash DD slash YYYY Signature*Click Submit below to become a part of our TEAM!Please wait until the form completely loads before closing browser or moving on in the app.NameThis field is for validation purposes and should be left unchanged.
