The Max Group Internet Partner Program Sign Up

Thank you for considering Max Group's Internet Partner (MGIP) Program for your business needs. To signup for the program, simply complete the form below and accept the Terms & Conditions. Once the form has been submitted, you will receive an acknowledgement email summarizing your order. A secondary email will be sent once your account has been activated and will contain your web site address and instructions on how to setup your site.

1. Ceneral Information
Max Group Account No.   
Your Name   
Company Name   
Telephone   
 – –
Email   
Desired Shopkey   
   (15 characters with no spaces)
2. Package Selection
Select a Package   
Be Billed   
3. Billing Information
Your Name   
Address   
City   
Zip Code
State   
Credit Card Type   
Credit Card No.   
CVV2   
 What is this?
Expiration Date   
    
Promotion Code   
  Yes, I agree to the MGIP Program Service Agreement.