Confirmation USA - Interactive Telephone and Electronic Communications. Message Broadcasting & Surveys

INDEPENDENT AGENTS

Confirmation USA currently has an opportunity for individuals in the Health Care Industry. If you have expienrence In Medical Sales we want to speak to you. Our products and Services are a necessity in today’s Medical World. We offer the highest residual compensation in the industry, along with many special incentives.

After completing registration you will be emailed a rep link. Use this link on your web site or in emails to get credit for the accounts you refer.

If you have any questions, please contact us.

Manage your agent account.

Independent Marketing Representative Agreement

INDEPENDENT AGENT REGISTRATION

Agent Name:
Phone:	- -
Address:

City:
State:
Zip Code :

Email Address:
Password:

Agent Referrer:
Agent Code:	To be determined.

How did you hear about Confirmation USA?


I understand that after completing the agent registration form, a Confirmation USA agent manager will contact me to further discuss the agent program.

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