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Affiliate & Agency Partner Application - My Equalize Digital Account

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!important;}.has-blush-bordeaux-gradient-background{background: var(--wp--preset--gradient--blush-bordeaux) !important;}.has-luminous-dusk-gradient-background{background: var(--wp--preset--gradient--luminous-dusk) !important;}.has-pale-ocean-gradient-background{background: var(--wp--preset--gradient--pale-ocean) !important;}.has-electric-grass-gradient-background{background: var(--wp--preset--gradient--electric-grass) !important;}.has-midnight-gradient-background{background: var(--wp--preset--gradient--midnight) !important;}.has-gradient-1-gradient-background{background: var(--wp--preset--gradient--gradient-1) !important;}.has-gradient-2-gradient-background{background: var(--wp--preset--gradient--gradient-2) !important;}.has-gradient-3-gradient-background{background: var(--wp--preset--gradient--gradient-3) !important;}.has-gradient-4-gradient-background{background: var(--wp--preset--gradient--gradient-4) !important;}.has-gradient-5-gradient-background{background: 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!important;}.has-x-large-font-size{font-size: var(--wp--preset--font-size--x-large) !important;}.has-large-body-font-size{font-size: var(--wp--preset--font-size--large-body) !important;}.has-xx-large-font-size{font-size: var(--wp--preset--font-size--xx-large) !important;}.has-body-font-family{font-family: var(--wp--preset--font-family--body) !important;}.has-heading-font-family{font-family: var(--wp--preset--font-family--heading) !important;}.has-system-sans-serif-font-family{font-family: var(--wp--preset--font-family--system-sans-serif) !important;}.has-system-serif-font-family{font-family: var(--wp--preset--font-family--system-serif) !important;} :root :where(.wp-block-pullquote){border-radius: var(--wp--preset--spacing--20);font-family: var(--wp--preset--font-family--heading);font-size: var(--wp--preset--font-size--x-large);font-style: italic;font-weight: 400;letter-spacing: 0em;line-height: 1.5;padding-top: var(--wp--preset--spacing--40);padding-bottom: var(--wp--preset--spacing--40);} :root :where(.wp-block-pullquote cite){font-family: var(--wp--preset--font-family--body);font-size: var(--wp--preset--font-size--medium);font-style: normal;} :root :where(.wp-block-avatar img){border-radius: 90px;} .wp-block-buttons-is-layout-flow > :first-child{margin-block-start: 0;}.wp-block-buttons-is-layout-flow > :last-child{margin-block-end: 0;}.wp-block-buttons-is-layout-flow > *{margin-block-start: 0.7rem;margin-block-end: 0;}.wp-block-buttons-is-layout-constrained > :first-child{margin-block-start: 0;}.wp-block-buttons-is-layout-constrained > :last-child{margin-block-end: 0;}.wp-block-buttons-is-layout-constrained > *{margin-block-start: 0.7rem;margin-block-end: 0;}.wp-block-buttons-is-layout-flex {gap: 0.7rem;}.wp-block-buttons-is-layout-grid {gap: 0.7rem;} :root :where(.wp-block-calendar table, .wp-block-calendar th){color: var(--wp--preset--color--contrast);}:root :where(.wp-block-calendar.wp-block-calendar 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calc(var(--wp--preset--spacing--30) + 0.75rem);padding-left: calc(var(--wp--preset--spacing--30) + 0.75rem);} :root :where(.wp-block-comment-author-name){color: var(--wp--preset--color--contrast);font-size: var(--wp--preset--font-size--small);font-style: normal;font-weight: 600;} :root :where(.wp-block-comment-author-name a:where(:not(.wp-element-button))){color: var(--wp--preset--color--contrast);text-decoration: none;} :root :where(.wp-block-comment-author-name a:where(:not(.wp-element-button)):hover){text-decoration: underline;} :root :where(.wp-block-comment-content){font-size: var(--wp--preset--font-size--small);margin-top: var(--wp--preset--spacing--20);margin-bottom: var(--wp--preset--spacing--20);} :root :where(.wp-block-comment-date){color: var(--wp--preset--color--contrast-2);font-size: var(--wp--preset--font-size--small);margin-top: 0px;margin-bottom: 0px;} :root :where(.wp-block-comment-date a:where(:not(.wp-element-button))){color: var(--wp--preset--color--contrast-2);text-decoration: none;} :root :where(.wp-block-comment-date a:where(:not(.wp-element-button)):hover){text-decoration: underline;} :root :where(.wp-block-comment-edit-link){font-size: var(--wp--preset--font-size--small);} :root :where(.wp-block-comment-edit-link a:where(:not(.wp-element-button))){color: var(--wp--preset--color--contrast-2);text-decoration: none;} :root :where(.wp-block-comment-edit-link a:where(:not(.wp-element-button)):hover){text-decoration: underline;} :root :where(.wp-block-comment-reply-link){font-size: var(--wp--preset--font-size--small);} :root :where(.wp-block-comment-reply-link a:where(:not(.wp-element-button))){color: var(--wp--preset--color--contrast-2);text-decoration: none;} :root :where(.wp-block-comment-reply-link a:where(:not(.wp-element-button)):hover){text-decoration: underline;} :root :where(.wp-block-post-comments-form){}:root :where(.wp-block-post-comments-form textarea, .wp-block-post-comments-form input){border-radius:.33rem} :root :where(.wp-block-comments-pagination){font-size: var(--wp--preset--font-size--small);} :root :where(.wp-block-comments-pagination-next){font-size: var(--wp--preset--font-size--small);} :root :where(.wp-block-comments-pagination-numbers){font-size: var(--wp--preset--font-size--small);} :root :where(.wp-block-comments-pagination-previous){font-size: var(--wp--preset--font-size--small);} :root :where(.wp-block-footnotes){font-size: var(--wp--preset--font-size--small);} :root :where(.wp-block-gallery){margin-bottom: var(--wp--preset--spacing--50);} :root :where(.wp-block-list){padding-left: var(--wp--preset--spacing--10);} :root :where(.wp-block-loginout){}:root :where(.wp-block-loginout input){border-radius:.33rem;padding:calc(0.667em + 2px);border:1px solid #949494;} :root :where(.wp-block-navigation){font-weight: 500;} :root :where(.wp-block-navigation a:where(:not(.wp-element-button))){text-decoration: underline;} :root :where(.wp-block-navigation 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class="site-main" role="main"> <article class="post-455 page type-page status-publish hentry"><div class="entry-content"><p class="prettyprint" style="text-align: center;" data-initialized="true" data-gclp-id="0"></p> <script type="text/javascript">var gform;gform||(document.addEventListener("gform_main_scripts_loaded",function(){gform.scriptsLoaded=!0}),window.addEventListener("DOMContentLoaded",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,initializeOnLoaded:function(o){gform.domLoaded&&gform.scriptsLoaded?o():!gform.domLoaded&&gform.scriptsLoaded?window.addEventListener("DOMContentLoaded",o):document.addEventListener("gform_main_scripts_loaded",o)},hooks:{action:{},filter:{}},addAction:function(o,n,r,t){gform.addHook("action",o,n,r,t)},addFilter:function(o,n,r,t){gform.addHook("filter",o,n,r,t)},doAction:function(o){gform.doHook("action",o,arguments)},applyFilters:function(o){return gform.doHook("filter",o,arguments)},removeAction:function(o,n){gform.removeHook("action",o,n)},removeFilter:function(o,n,r){gform.removeHook("filter",o,n,r)},addHook:function(o,n,r,t,i){null==gform.hooks[o][n]&&(gform.hooks[o][n]=[]);var e=gform.hooks[o][n];null==i&&(i=n+"_"+e.length),gform.hooks[o][n].push({tag:i,callable:r,priority:t=null==t?10:t})},doHook:function(n,o,r){var t;if(r=Array.prototype.slice.call(r,1),null!=gform.hooks[n][o]&&((o=gform.hooks[n][o]).sort(function(o,n){return o.priority-n.priority}),o.forEach(function(o){"function"!=typeof(t=o.callable)&&(t=window[t]),"action"==n?t.apply(null,r):r[0]=t.apply(null,r)})),"filter"==n)return r[0]},removeHook:function(o,n,t,i){var r;null!=gform.hooks[o][n]&&(r=(r=gform.hooks[o][n]).filter(function(o,n,r){return!!(null!=i&&i!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][n]=r)}});</script> <div class='gf_browser_ie gf_browser_ie7 gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' 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clip-rule='evenodd' d='M0.292893 0.292893C0.683417 -0.097631 1.31658 -0.097631 1.70711 0.292893L5 3.58579L8.29289 0.292893C8.68342 -0.0976311 9.31658 -0.0976311 9.70711 0.292893C10.0976 0.683417 10.0976 1.31658 9.70711 1.70711L5.70711 5.70711C5.31658 6.09763 4.68342 6.09763 4.29289 5.70711L0.292893 1.70711C-0.0976311 1.31658 -0.0976311 0.683418 0.292893 0.292893Z' fill='rgba(17, 35, 55, 0.65)'/%3E%3C/svg%3E");--gf-icon-ctrl-search: url("data:image/svg+xml,%3Csvg version='1.1' xmlns='http://www.w3.org/2000/svg' width='640' height='640'%3E%3Cpath d='M256 128c-70.692 0-128 57.308-128 128 0 70.691 57.308 128 128 128 70.691 0 128-57.309 128-128 0-70.692-57.309-128-128-128zM64 256c0-106.039 85.961-192 192-192s192 85.961 192 192c0 41.466-13.146 79.863-35.498 111.248l154.125 154.125c12.496 12.496 12.496 32.758 0 45.254s-32.758 12.496-45.254 0L367.248 412.502C335.862 434.854 297.467 448 256 448c-106.039 0-192-85.962-192-192z' fill='rgba(17, 35, 55, 0.65)'/%3E%3C/svg%3E");--gf-label-space-y-secondary: var(--gf-label-space-y-md-secondary);--gf-ctrl-border-color: #686e77;--gf-ctrl-size: var(--gf-ctrl-size-md);--gf-ctrl-label-color-primary: #112337;--gf-ctrl-label-color-secondary: #112337;--gf-ctrl-choice-size: var(--gf-ctrl-choice-size-md);--gf-ctrl-checkbox-check-size: var(--gf-ctrl-checkbox-check-size-md);--gf-ctrl-radio-check-size: var(--gf-ctrl-radio-check-size-md);--gf-ctrl-btn-font-size: var(--gf-ctrl-btn-font-size-md);--gf-ctrl-btn-padding-x: var(--gf-ctrl-btn-padding-x-md);--gf-ctrl-btn-size: var(--gf-ctrl-btn-size-md);--gf-ctrl-btn-border-color-secondary: #686e77;--gf-ctrl-file-btn-bg-color-hover: #EBEBEB;--gf-field-pg-steps-number-color: rgba(17, 35, 55, 0.8);}</style> <div class='gform_heading'> <p class='gform_description'><p style="background-color: #f3f4fe; padding: 20px; border-radius: 5px; margin-top: 60px;">Fill out the following form to apply to join our affiliate or Agency Partner programs. <strong>If you have an Accessibility Checker Pro account, please log in before submitting this application.</strong></p></p> </div><form method='post' enctype='multipart/form-data' id='gform_7' action='/affiliates-join/' data-formid='7' novalidate> <div class='gform-body gform_body'><div id='gform_fields_7' class='gform_fields top_label form_sublabel_below description_above validation_below'><fieldset id="field_7_22" class="gfield gfield--type-name gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible" data-js-reload="field_7_22" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Name<span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_7_22'> <span id='input_7_22_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' > <input type='text' name='input_22.3' id='input_7_22_3' value='' aria-required='true' autocomplete="given-name" /> <label for='input_7_22_3' class='gform-field-label gform-field-label--type-sub '>First</label> </span> <span id='input_7_22_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' > <input type='text' name='input_22.6' id='input_7_22_6' value='' aria-required='true' autocomplete="family-name" /> <label for='input_7_22_6' class='gform-field-label gform-field-label--type-sub '>Last</label> </span> </div></fieldset><fieldset id="field_7_26" class="gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible" data-js-reload="field_7_26" ><legend class='gfield_label gform-field-label' >Would you like to join our Agency Partner program?<span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></legend><div class='gfield_description' id='gfield_description_7_26'>In addition to receiving a 20% affiliate commission on all referrals, verified agencies in our Agency Partner Program receive a 20% discount on Rapid Audits. This enables agencies to purchase audits on behalf of their clients and markup the audits as desired.</div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_7_26'> <div class='gchoice gchoice_7_26_0'> <input class='gfield-choice-input' name='input_26' type='radio' value='Yes, I am applying for an agency.' id='choice_7_26_0' onchange='gformToggleRadioOther( this )' aria-describedby="gfield_description_7_26" /> <label for='choice_7_26_0' id='label_7_26_0' class='gform-field-label gform-field-label--type-inline'>Yes, I am applying for an agency.</label> </div> <div class='gchoice gchoice_7_26_1'> <input class='gfield-choice-input' name='input_26' type='radio' value='No, I&#039;m only interested in the affiliate program.' id='choice_7_26_1' onchange='gformToggleRadioOther( this )' /> <label for='choice_7_26_1' id='label_7_26_1' class='gform-field-label gform-field-label--type-inline'>No, I'm only interested in the affiliate program.</label> </div></div></div></fieldset><div id="field_7_27" class="gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible" data-js-reload="field_7_27" ><label class='gfield_label gform-field-label' for='input_7_27'>Agency/Business Name<span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></label><div class='ginput_container ginput_container_text'><input name='input_27' id='input_7_27' type='text' value='' class='large' aria-required="true" aria-invalid="false" autocomplete="organization" /> </div></div><fieldset id="field_7_28" class="gfield gfield--type-address gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible" data-js-reload="field_7_28" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Business Address<span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></legend> <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip has_country ginput_container_address gform-grid-row' id='input_7_28' > <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_7_28_1_container' > <input type='text' name='input_28.1' id='input_7_28_1' value='' aria-required='true' autocomplete="address-line1" /> <label for='input_7_28_1' id='input_7_28_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address</label> </span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_7_28_2_container' > <input type='text' name='input_28.2' id='input_7_28_2' value='' autocomplete="address-line2" aria-required='false' /> <label for='input_7_28_2' id='input_7_28_2_label' class='gform-field-label gform-field-label--type-sub '>Address Line 2</label> </span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_7_28_3_container' > <input type='text' name='input_28.3' id='input_7_28_3' value='' aria-required='true' autocomplete="address-level2" /> <label for='input_7_28_3' id='input_7_28_3_label' class='gform-field-label gform-field-label--type-sub '>City</label> </span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_7_28_4_container' > <input type='text' name='input_28.4' id='input_7_28_4' value='' aria-required='true' autocomplete="address-level1" /> <label for='input_7_28_4' id='input_7_28_4_label' class='gform-field-label gform-field-label--type-sub '>State / Province / Region</label> </span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_7_28_5_container' > <input type='text' name='input_28.5' id='input_7_28_5' value='' aria-required='true' autocomplete="postal-code" /> <label for='input_7_28_5' id='input_7_28_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP / Postal Code</label> </span><span class='ginput_right address_country ginput_address_country gform-grid-col' id='input_7_28_6_container' > <select name='input_28.6' id='input_7_28_6' aria-required='true' autocomplete="country" ><option value='' ></option><option value='Afghanistan' >Afghanistan</option><option value='Albania' >Albania</option><option value='Algeria' >Algeria</option><option value='American Samoa' >American Samoa</option><option value='Andorra' >Andorra</option><option value='Angola' >Angola</option><option value='Anguilla' >Anguilla</option><option value='Antarctica' >Antarctica</option><option value='Antigua and Barbuda' >Antigua and Barbuda</option><option value='Argentina' >Argentina</option><option value='Armenia' >Armenia</option><option value='Aruba' >Aruba</option><option value='Australia' >Australia</option><option value='Austria' >Austria</option><option value='Azerbaijan' >Azerbaijan</option><option value='Bahamas' >Bahamas</option><option value='Bahrain' >Bahrain</option><option value='Bangladesh' >Bangladesh</option><option value='Barbados' >Barbados</option><option value='Belarus' >Belarus</option><option value='Belgium' >Belgium</option><option value='Belize' >Belize</option><option value='Benin' >Benin</option><option value='Bermuda' >Bermuda</option><option value='Bhutan' >Bhutan</option><option value='Bolivia' >Bolivia</option><option value='Bonaire, Sint Eustatius and Saba' >Bonaire, Sint Eustatius and Saba</option><option value='Bosnia and Herzegovina' >Bosnia and Herzegovina</option><option value='Botswana' >Botswana</option><option value='Bouvet Island' >Bouvet Island</option><option value='Brazil' >Brazil</option><option value='British Indian Ocean Territory' >British Indian Ocean Territory</option><option value='Brunei Darussalam' >Brunei Darussalam</option><option value='Bulgaria' >Bulgaria</option><option value='Burkina Faso' >Burkina Faso</option><option value='Burundi' >Burundi</option><option value='Cabo Verde' >Cabo Verde</option><option value='Cambodia' >Cambodia</option><option value='Cameroon' >Cameroon</option><option value='Canada' >Canada</option><option value='Cayman Islands' >Cayman Islands</option><option value='Central African Republic' >Central African Republic</option><option value='Chad' >Chad</option><option value='Chile' >Chile</option><option value='China' >China</option><option value='Christmas Island' >Christmas Island</option><option value='Cocos Islands' >Cocos Islands</option><option value='Colombia' >Colombia</option><option value='Comoros' >Comoros</option><option value='Congo' >Congo</option><option value='Congo, Democratic Republic of the' >Congo, Democratic Republic of the</option><option value='Cook Islands' >Cook Islands</option><option value='Costa Rica' >Costa Rica</option><option value='Croatia' >Croatia</option><option value='Cuba' >Cuba</option><option value='Cura莽ao' >Cura莽ao</option><option value='Cyprus' >Cyprus</option><option value='Czechia' >Czechia</option><option value='C么te d&#039;Ivoire' >C么te d&#039;Ivoire</option><option value='Denmark' >Denmark</option><option value='Djibouti' >Djibouti</option><option value='Dominica' >Dominica</option><option value='Dominican Republic' >Dominican Republic</option><option value='Ecuador' >Ecuador</option><option value='Egypt' >Egypt</option><option value='El Salvador' >El Salvador</option><option value='Equatorial Guinea' >Equatorial Guinea</option><option value='Eritrea' >Eritrea</option><option value='Estonia' >Estonia</option><option value='Eswatini' >Eswatini</option><option value='Ethiopia' >Ethiopia</option><option value='Falkland Islands' >Falkland Islands</option><option value='Faroe Islands' >Faroe Islands</option><option value='Fiji' >Fiji</option><option value='Finland' >Finland</option><option value='France' >France</option><option value='French Guiana' >French Guiana</option><option value='French Polynesia' >French Polynesia</option><option value='French Southern Territories' >French Southern Territories</option><option value='Gabon' >Gabon</option><option value='Gambia' >Gambia</option><option value='Georgia' >Georgia</option><option value='Germany' >Germany</option><option value='Ghana' >Ghana</option><option value='Gibraltar' >Gibraltar</option><option value='Greece' >Greece</option><option value='Greenland' >Greenland</option><option value='Grenada' >Grenada</option><option value='Guadeloupe' >Guadeloupe</option><option value='Guam' >Guam</option><option value='Guatemala' >Guatemala</option><option value='Guernsey' >Guernsey</option><option value='Guinea' >Guinea</option><option value='Guinea-Bissau' >Guinea-Bissau</option><option value='Guyana' >Guyana</option><option value='Haiti' >Haiti</option><option value='Heard Island and McDonald Islands' >Heard Island and McDonald Islands</option><option value='Holy See' >Holy See</option><option value='Honduras' >Honduras</option><option value='Hong Kong' >Hong Kong</option><option value='Hungary' >Hungary</option><option value='Iceland' >Iceland</option><option value='India' >India</option><option value='Indonesia' >Indonesia</option><option value='Iran' >Iran</option><option value='Iraq' >Iraq</option><option value='Ireland' >Ireland</option><option value='Isle of Man' >Isle of Man</option><option value='Israel' >Israel</option><option value='Italy' >Italy</option><option value='Jamaica' >Jamaica</option><option value='Japan' >Japan</option><option value='Jersey' >Jersey</option><option value='Jordan' >Jordan</option><option value='Kazakhstan' >Kazakhstan</option><option value='Kenya' >Kenya</option><option value='Kiribati' >Kiribati</option><option value='Korea, Democratic People&#039;s Republic of' >Korea, Democratic People&#039;s Republic of</option><option value='Korea, Republic of' >Korea, Republic of</option><option value='Kuwait' >Kuwait</option><option value='Kyrgyzstan' >Kyrgyzstan</option><option value='Lao People&#039;s Democratic Republic' >Lao People&#039;s Democratic Republic</option><option value='Latvia' >Latvia</option><option value='Lebanon' >Lebanon</option><option value='Lesotho' >Lesotho</option><option value='Liberia' >Liberia</option><option value='Libya' >Libya</option><option value='Liechtenstein' >Liechtenstein</option><option value='Lithuania' >Lithuania</option><option value='Luxembourg' >Luxembourg</option><option value='Macao' >Macao</option><option value='Madagascar' >Madagascar</option><option value='Malawi' >Malawi</option><option value='Malaysia' >Malaysia</option><option value='Maldives' >Maldives</option><option value='Mali' >Mali</option><option value='Malta' >Malta</option><option value='Marshall Islands' >Marshall Islands</option><option value='Martinique' >Martinique</option><option value='Mauritania' >Mauritania</option><option value='Mauritius' >Mauritius</option><option value='Mayotte' >Mayotte</option><option value='Mexico' >Mexico</option><option value='Micronesia' >Micronesia</option><option value='Moldova' >Moldova</option><option value='Monaco' >Monaco</option><option value='Mongolia' >Mongolia</option><option value='Montenegro' >Montenegro</option><option value='Montserrat' >Montserrat</option><option value='Morocco' >Morocco</option><option value='Mozambique' >Mozambique</option><option value='Myanmar' >Myanmar</option><option value='Namibia' >Namibia</option><option value='Nauru' >Nauru</option><option value='Nepal' >Nepal</option><option value='Netherlands' >Netherlands</option><option value='New Caledonia' >New Caledonia</option><option value='New Zealand' >New Zealand</option><option value='Nicaragua' >Nicaragua</option><option value='Niger' >Niger</option><option value='Nigeria' >Nigeria</option><option value='Niue' >Niue</option><option value='Norfolk Island' >Norfolk Island</option><option value='North Macedonia' >North Macedonia</option><option value='Northern Mariana Islands' >Northern Mariana Islands</option><option value='Norway' >Norway</option><option value='Oman' >Oman</option><option value='Pakistan' >Pakistan</option><option value='Palau' >Palau</option><option value='Palestine, State of' >Palestine, State of</option><option value='Panama' >Panama</option><option value='Papua New Guinea' >Papua New Guinea</option><option value='Paraguay' >Paraguay</option><option value='Peru' >Peru</option><option value='Philippines' >Philippines</option><option value='Pitcairn' >Pitcairn</option><option value='Poland' >Poland</option><option value='Portugal' >Portugal</option><option value='Puerto Rico' >Puerto Rico</option><option value='Qatar' >Qatar</option><option value='Romania' >Romania</option><option value='Russian Federation' >Russian Federation</option><option value='Rwanda' >Rwanda</option><option value='R茅union' >R茅union</option><option value='Saint Barth茅lemy' >Saint Barth茅lemy</option><option value='Saint Helena, Ascension and Tristan da Cunha' >Saint Helena, Ascension 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>Tonga</option><option value='Trinidad and Tobago' >Trinidad and Tobago</option><option value='Tunisia' >Tunisia</option><option value='Turkmenistan' >Turkmenistan</option><option value='Turks and Caicos Islands' >Turks and Caicos Islands</option><option value='Tuvalu' >Tuvalu</option><option value='T眉rkiye' >T眉rkiye</option><option value='US Minor Outlying Islands' >US Minor Outlying Islands</option><option value='Uganda' >Uganda</option><option value='Ukraine' >Ukraine</option><option value='United Arab Emirates' >United Arab Emirates</option><option value='United Kingdom' >United Kingdom</option><option value='United States' selected='selected'>United States</option><option value='Uruguay' >Uruguay</option><option value='Uzbekistan' >Uzbekistan</option><option value='Vanuatu' >Vanuatu</option><option value='Venezuela' >Venezuela</option><option value='Viet Nam' >Viet Nam</option><option value='Virgin Islands, British' >Virgin Islands, British</option><option value='Virgin Islands, U.S.' >Virgin Islands, U.S.</option><option value='Wallis and Futuna' >Wallis and Futuna</option><option value='Western Sahara' >Western Sahara</option><option value='Yemen' >Yemen</option><option value='Zambia' >Zambia</option><option value='Zimbabwe' >Zimbabwe</option><option value='脜land Islands' >脜land Islands</option></select> <label for='input_7_28_6' id='input_7_28_6_label' class='gform-field-label gform-field-label--type-sub '>Country</label> </span> <div class='gf_clear gf_clear_complex'></div> </div></fieldset><div id="field_7_29" class="gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible" data-js-reload="field_7_29" ><label class='gfield_label gform-field-label' for='input_7_29'>EIN<span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></label><div class='ginput_container ginput_container_text'><input name='input_29' id='input_7_29' type='text' value='' class='medium' aria-required="true" aria-invalid="false" /> </div></div><div id="field_7_30" class="gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible" data-js-reload="field_7_30" ><label class='gfield_label gform-field-label' for='input_7_30'>VAT<span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></label><div class='ginput_container ginput_container_text'><input name='input_30' id='input_7_30' type='text' value='' class='medium' aria-required="true" aria-invalid="false" /> </div></div><div id="field_7_3" class="gfield gfield--type-website gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible" data-js-reload="field_7_3" ><label class='gfield_label gform-field-label' for='input_7_3'>Website URL<span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></label><div class='gfield_description' id='gfield_description_7_3'>Enter the URL of your website (include http:// or https://) for the website where to plan to promote our products.</div><div class='ginput_container ginput_container_website'> <input name='input_3' id='input_7_3' type='url' value='' class='large' aria-describedby="gfield_description_7_3" aria-required="true" aria-invalid="false"/> </div></div><div id="field_7_8" class="gfield gfield--type-username goodbye gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible" data-js-reload="field_7_8" ><label class='gfield_label gform-field-label' for='input_7_8'>Username<span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></label><div class='gfield_description' id='gfield_description_7_8'>You'll use this to log into our site and it will also be publically visible in the referral URLs you'll share.</div><div class='ginput_container ginput_container_text'><input name='input_8' id='input_7_8' type='text' value='' class='medium' aria-describedby="input_7_8_desc gfield_description_7_8" aria-required="true" aria-invalid="false" autocomplete="username" /> </div></div><div id="field_7_1" class="gfield gfield--type-email hello gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible" data-js-reload="field_7_1" ><label class='gfield_label gform-field-label' for='input_7_1'>Account Email<span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></label><div class='gfield_description' id='gfield_description_7_1'>Enter the email address you would like connected to your account on our website.</div><div class='ginput_container ginput_container_email'> <input name='input_1' id='input_7_1' type='email' value='' class='large' aria-required="true" aria-invalid="false" aria-describedby="gfield_description_7_1" autocomplete="email"/> </div></div><div id="field_7_9" class="gfield gfield--type-payment_email test1 test2 field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible" data-js-reload="field_7_9" ><label class='gfield_label gform-field-label' for='input_7_9'>Payment Email</label><div class='gfield_description' id='gfield_description_7_9'>If different from your account email, enter the email you use for PayPal (so we can pay you).</div><div class='ginput_container ginput_container_email'> <input name='input_9' id='input_7_9' type='email' value='' class='large' aria-invalid="false" aria-describedby="gfield_description_7_9" /> </div></div><div id="field_7_15" class="gfield gfield--type-promotion_method gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible" data-js-reload="field_7_15" ><label class='gfield_label gform-field-label' for='input_7_15'>How will you promote us?<span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></label><div class='gfield_description' id='gfield_description_7_15'>Please share any relevant information about how you plan to promote Equalize Digital and Accessibility Checker. Please be as specific as possible.</div><div class='ginput_container ginput_container_textarea'><textarea name='input_15' id='input_7_15' class='textarea medium' aria-describedby="gfield_description_7_15" aria-required="true" aria-invalid="false" rows='10' cols='50'></textarea></div></div><div id="field_7_24" class="gfield gfield--type-textarea field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible" data-js-reload="field_7_24" ><label class='gfield_label gform-field-label' for='input_7_24'>Social media URLs</label><div class='gfield_description' id='gfield_description_7_24'>Please provide links to your existing social media accounts or any social media accounts where you plan to promote us.</div><div class='ginput_container ginput_container_textarea'><textarea name='input_24' id='input_7_24' class='textarea medium' aria-describedby="gfield_description_7_24" aria-invalid="false" rows='10' cols='50'></textarea></div></div><fieldset id="field_7_25" class="gfield gfield--type-radio gfield--type-choice gf_list_inline gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible" data-js-reload="field_7_25" ><legend class='gfield_label gform-field-label' >Do you have an active Accessibility Checker Pro license?<span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_7_25'> <div class='gchoice gchoice_7_25_0'> <input class='gfield-choice-input' name='input_25' type='radio' value='Yes' id='choice_7_25_0' onchange='gformToggleRadioOther( this )' /> <label for='choice_7_25_0' id='label_7_25_0' class='gform-field-label gform-field-label--type-inline'>Yes</label> </div> <div class='gchoice gchoice_7_25_1'> <input class='gfield-choice-input' name='input_25' type='radio' value='No' id='choice_7_25_1' onchange='gformToggleRadioOther( this )' /> <label for='choice_7_25_1' id='label_7_25_1' class='gform-field-label gform-field-label--type-inline'>No</label> </div></div></div></fieldset><fieldset id="field_7_23" class="gfield gfield--type-checkbox gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible" data-js-reload="field_7_23" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Terms of Use<span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_7_23'><div class='gchoice gchoice_7_23_1'> <input class='gfield-choice-input' name='input_23.1' type='checkbox' value='I have read and agree to the &lt;a href=&quot;https://my.equalizedigital.com/affiliates/terms/&quot; 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