Partner Application

Affiliate Information
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This information will be used to place you in the beSure Affiliate that suits you best.

Personal Information

Business Information


Profile/Social Media Information

Please take a few minutes to provide this information so we can complete your profile upon approval of your application. This information will allow us to tag you in posts that will help your business grow!

(please fill in complete format

Application Requirements

Please check off each statement below to acknowledge you have read, understand and agree to the beSure application requirements.


Please choose your Preferred investment in the beSure organization. Members following our system have received average revenue in excess of $10,000 with some members receiving revenue in the hundreds of thousands of dollars! (this is not a guarantee and your individual results will vary based on business category, personal engagement and other factors)

By choosing a membership term below you agree that you are entering into a contract for the term of your choice. Should you vacate your membership in beSure or if your membership in beSure is terminated due to your failure to maintain minimum requirements, you will be charged for the full term of your membership and will be billed periodically until your Investment is paid in full.

1-Year Membership
2-Year Membership - BEST VALUE!

Payment/Billing Address

Please provide your Billing Address here. For security purposes, a representative from beSure will call you to accept your payment over the phone. Thank you!

Disclaimer: I attest that the information provided in this application is true and accurate to the best of my knowledge. I understand that if my application is approved by beSure and I am selected as a Partner, I will be charged for my entire chosen membership term either one-time, quarterly, or monthly based on my selection above.

I also attest that I have read and understood    BeSure Guidelines    &    BeSure Activity Scorecard.   

* Indicates the required fields