Affiliate Application

Below is an application to become an affiliate with Prescription Audio. When submitting this form, an account will be created for you with the site and we will be notified of your application. If approved, you will receive an email with account details as well as further instructions for getting started. You will also be notified by email if you are not approved. It is important you fill out all of this information accurately, and that you read and fully understand the terms and conditions. Thank you.

Please check this box if you are an MHA Affiliate.

Terms & Conditions

Please note that payments will be distributes to PayPal accounts only. You must have a PayPal account that funds can be placed into before receiving payment.

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