GENI Affiliate Application

GENI wants you and your closest GENI supporters (a minimum of 3 committed people) to become a GENI Affiliate. GENI Affiliates raise money for GENI and promote GENI in your local area.

GENI's affiliates can be linked to our web site. GENI's affiliates will have access to special reports and fundraising data.

How to Join

Fill in the GENI Affiliate application below. Upon approval we will email you an information package and instructions on getting started.

Payor/Payee Information
Please fill out the name and contact information of the person from whom we will receive checks or to whom we should make checks payable.
Payor/Payee's Name:
Address:
City/Town:
State:
ZIP/Postal Code:
Phone Number:
Email Address:
Contact 1 Information
Please fill out the name and address of the person to whom we should address correspondence regarding your participation in our Affiliate program.
Contact 1's Name:
Contact 1 Address:
Contact 1 City/Town:
Contact 1 State:
Contact 1 Zip Code:
Contact 1 Phone Number:
Contact 1 Email Address:
Contact 2 Information
Please fill out the name and address of the person to whom we should address correspondence regarding your participation in our Affiliate program.
Contact 2's Name:
Contact 2 Address:
Contact 2 City/Town:
Contact 2 State:
Contact 2 Zip Code:
Contact 2 Phone Number:
Contact 2 Email Address:
Contact 3 Information
Please fill out the name and address of the person to whom we should address correspondence regarding your participation in our Affiliate program.
Contact 3's Name:
Contact 3 Address:
Contact 3 City/Town:
Contact 3 State:
Contact 3 Zip Code:
Contact 3 Phone Number:
Contact 3 Email Address:
Your Website
Please enter the URL of the Web site through which you intend to link to geni.org.
URL of Website: