Direct Selling Women's Alliance

Thank you for joining our growing network of Corporate Members.
We look forward to working with you to create your personal web listing.

Please Note : The information you provide in the fields marked with an asterisk (*) will be shown exactly as written in your personal web listing of our public search engines.

Company Name *

E-mail Address *

Website *

Primary Address *

City *

State *

Zip/Postal Code *

Country

Only provide a Shipping Address if different from Primary Address.

Shipping Address

City

State

Zip/Postal Code

Country

Please enter country code, area code and number without dashes or spaces.

Day Phone *

Fax

Contact Person For DSWA Corporate Use

First Name

Last Name

Title

E-mail Address

Who referred you to DSWA? Please provide their Member Identification Number (MIN)

How can the DSWA meet your needs?

YOUR PRIVATE PASSWORD

To ensure your privacy and enable you to make changes to your web page, please establish a unique User Name and User Password.

Enter your Company

User Name:

Password (6-10 letters, numbers or symbols):

TO SERVE YOU BETTER

The following information is required if you wish to be listed in our "Hot Products" search.

How many years have you been in business?

Do you offer a Satisfaction Guarantee? Yes No

What types of products & services do you offer?

Show/Party Supplies

Sales Aids

Books, Tapes and CDs

Display Items

Technology/Communication

Lead Generation

Travel

Awards & Incentives

Financial

Business Building Tools

Other
(Suggest a new product/service category)

What is the average price of your products and/or services?

$1 - $24

$25 - $49

$50 - $99

$100 - $199

$200 and up

Do you offer marketing materials in Spanish? Yes No

Do you offer customer service support in Spanish? Yes No

PAYMENT TERMS

Select Your Pay Plan:

Payment In Full
I am submitting payment for my Annual Membership Fee of $500 US.

Select Your Payment Method:

Payment By Credit/Debit Card

Credit Card Type
Name on Card
Credit/Debit Card Number
Expiration Date	Mo	Yr
Billing Address:
City
State
Zip/Postal code
Country

Payment By Check
(Make check payable to the DSWA and send it to: DSWA, 111 Hekili St., Suite A-139
Kailua, HI. 96734)

"Caution: click on "submit" only once!"