QVC

Affiliate Connection Newsletter Update Form

Directions: Fill in this form to update your current Affiliate Connection newsletter information or if you would like to receive our newsletter on a quarterly basis. Print this form and fax to 484.701.1350.

Name:

Title:

System Name:

Office Address/PO Box:

City: State: Zip:

Office Phone: - -    Ext:    Fax: - -

Direct Line: - -    Ext:    Fax: - -

E-Mail:

Please check one box below:

Please continue to send me the Affiliate Connection newsletter. I am updating the above information only.

Please change the Affiliate Connection newsletter quantity I am currently receiving to the following:

I would like to begin receiving the Affiliate Connection newsletter on a quarterly basis. Please send me the following quantities:

I do not wish to receive the Affiliate Connection newsletter any longer. Thank you.

Print this form and fax to 484.701.1350. Thank You!