Human Locomotion

Affiliates

“If you really look closely, most overnight successes took a long time.”  

– Steve Jobs

Register as Affiliate

First Name

Your first name.

Last Name

Your last name.

Website

Your company website

Username

Your username.

Account Email

Your primary email, used for logging in.

Payment Email (PayPal)

Your PayPal payment email, to which we will send commission payments. Can be the same as your account email.

Mailing Address

This is only required if you do not have a PayPal email for payment.

Password

Your primary password, used for logging in.

Do you specialize in Lower Extremity Rehabilitation?
How many & what type of providers do you have at your practice?

(example: 2 DC, 1 PT, 1 LMT)

How will you promote Human Locomotion products?

Let us know a bit about yourself and how you plan on promoting Human Locomotion products. Please be as detailed as possible. We review every application individually and decide whether or not to approve an affiliate based on these answers.


Your account will need to be approved before you can earn Referrals. You'll receive an email once it's approved.