Contact Name:*

Business Name:

Business Registration Number:

Phone Number:

Fax Number:

Postal Address:

City:

State:

Postal code:

Country:

Email Address:*

Web site:

What is your Business category?

• I have a current website and am looking to add flowers and/or gifts to my product range
• I am in the process of constructing a website and am looking to add flowers and/or gifts to my product range
• I currently have a website that sells flowers and/or gifts and am looking to change suppliers
• I have a current or potential Member Group (eg. shopping discounts, member benefits) and am interested in providing them with a discount on their flower and/or gift purchases
• Other:

How do you hear about us?

• I searched for 'flower and/or gift affiliate programs'
• I searched for 'affiliate programs' in general
• I found Petals or Grumleys by searching using other keywords.
• I have seen Petals Network or Grumleys Gifts on other Affiliate sites
• I have been recommended to contact Petals or Grumleys by other Affiliates
• I have used Petals or Grumleys before
• Other:

Your commission or discount structure will depend on the way in which you'd like to trade with Petals Network and Grumleys Gifts. How would you like to collect your Petals Network and/or Grumleys Orders?

• I'd like to place a link to Petals and/or Grumleys on my site to collect orders (Affiliate Option 1)
• I'd like to use my site's own shopping cart to collect orders (Affiliate Option 2)
• I'm unsure how to collect orders and need assistance to work out my best option

Orders collected through a shopping cart will need to be sent to Petals Network / Grumleys. How would you like to send these orders ?

• Online via the Petals/Grumleys Ordering Website
• Petals / Grumleys API Interface (XML)
• Unsure

This can be based on your other product sales if you have a current website.

• 1 - 10 orders per month
• 10 - 20 orders per month
• 20 or more per month
• Unsure

What is your site's current traffic stats per month:

How helpful was this site:

• 1 - Poor
• 2
• 3
• 4
• 5 - Excellent

Extra Information/Comments

What is the sum of 1 + 1?*

Thank you for completing the Registration of Interest form. Petals will process your form and will be in contact with you.