Brand Ambassador Program

• First Name
• Last Name

• Street

• City
• State Alabama (AL)Alaska (AK)Arizona (AZ)Arkansas (AR)California (CA)Colorado (CO)Connecticut (CT)Delaware (DE)District of Columbia (DC)Florida (FL)Georgia (GA)Hawaii (HI)Idaho (ID)Illinois (IL)Indiana (IN)Iowa (IA)Kansas (KS)Kentucky (KY)Louisiana (LA)Maine (ME)Maryland (MD)Massachusetts (MA)Michigan (MI)Minnesota (MN)Mississippi (MS)Missouri (MO)Montana (MT)Nebraska (NE)Nevada (NV)New Hampshire (NH)New Jersey (NJ)New Mexico (NM)New York (NY)North Carolina (NC)North Dakota (ND)Ohio (OH)Oklahoma (OK)Oregon (OR)Pennsylvania (PA)Rhode Island (RI)South Carolina (SC)South Dakota (SD)Tennessee (TN)Texas (TX)Utah (UT)Vermont (VT)Virginia (VA)Washington (WA)West Virginia (WV)Wisconsin (WI)Wyoming (WY)
• Zip

• Phone
• E-mail

• Instagram Username:
• Instagram Followers:

• TikTok Username:
• TikTok Followers:

• Twitter Profile:
• Twitter Followers:

• Facebook Profile:
• Facebook Followers:

• YouTube Channel Link:
• YouTube Subscribers:

• Tell us about yourself:

• Are you currently a Brand Ambassador?

  YesNo

• If yes, please list brands:

• Link to previous branded content:

• Core Industry:

  LifestyleTechnologyFashionHome DecorOther
• Core Demographic:

  MaleFemaleOther
• Core Demographic Age Range:

  18-2425-3031-4445-5555+All above

• Do you currently use a TV antenna or have you used a TV antenna in the past?

• If yes, what brand and what is your antenna experience like?

• Compensation Expectation

  Affiliate Link to GoMohuAffiliate Link + Production Fee

• Opt in for marketing emails, product launches, promotions and giveaways:

  Yes No

Current month ye@r (4 digits) day *

Leave this field empty *