Influencer

Influencer Collaboration Application Form

Company Name: Herbal Pharma

Purpose: Social Media Promotion & Brand Collaboration

1. Personal Information

Full Name *

Date of Birth *

Gender *
[radio* gender use_label_element "Male" "Female" "Other"]

Mobile Number *

Email Address *

City / Country *

2. Social Media Profile Details

Instagram Username

Instagram Followers

YouTube Channel Name

YouTube Subscribers

Facebook Page

Facebook Followers

Other Platforms

TikTokTwitter / XSnapchatOther

If Other, Please Specify

Profile Links

3. Content Category

Health & WellnessFitnessBeauty & SkincareLifestyleAyurveda / Herbal ProductsOther

If Other, Please Specify

4. Audience Details

Primary Audience Location

Audience Age Group

18–2525–3535–4545+

Average Views per Post / Reel

5. Collaboration Type

Product ReviewSponsored PostInstagram Reel / Short VideoYouTube VideoAffiliate PromotionBrand Ambassador Program

6. Previous Brand Collaborations

Have you worked with other brands before?

YesNo

If Yes, Please Mention

7. Content Proposal

How would you promote our herbal products?

8. Payment / Collaboration Preference

Paid PromotionProduct ExchangeAffiliate CommissionLong-Term Partnership

Additional Comments

I confirm that the information provided above is true and accurate.