Amazon Seller Management Application

1

What's your name?* This field is required.

First Name

Last Name

2

What's your best email?* This field is required.By clicking the button above you consent for our partners or us to contact you by mail, phone, text, or email using automated technology to the data provided, even if the contact info is on a state or national DNC list. You also consent to our Privacy Policy and Terms of Service.

3

Phone Number* This field is required.

Please enter a valid phone number.

4

Social Media URLCopy and paste your social media profile links (Instagram, YouTube, Twitter/X)

5

What do you want to talk about?Please provide 2-3 sentences on what you'd like to talk about.

6

Website

7

Social Media URLCopy and paste your social media profile links (Instagram, YouTube, Twitter/X)

8

Do You Want to be Added as a Collaborator on the IG Posts? (ex. https://www.instagram.com/reel/CwvA3MFLI8C)* This field is required.This allows us to determine what strategies to use to grow your store.

Yes

No

9

Do You Wish to Be added to The Modern Way Community?* This field is required.A community of entrepreneurs living the modern way.

Yes

No

10

Do You Wish to Be Private Modern Way Guest Community?* This field is required.A Group chat for all prior guests to be able to connect/collaborate

Yes

No

11

Do you want the raw footage of the content after the show to repurpose for your own content?* This field is required.

Yes

No

12

If you are selected there is a $2,000 appearance fee* This field is required.

Yes

No

13

Agent ID

14

Channel ID

15

Ad ID

16

Campaign ID

17

utm_source

18

utm_medium

19

utm_campaign

20

utm_content

21

Referrer

22

Please verify that you are human* This field is required.