Wholesale Access — Love her Madly
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Wholesale Access

<form action="http://awesomeshop.gkapp.com/remote/signup" method="post">
  <input type="hidden" name="data[return_url]" value="http://awesomeshop.myshopify.com/pages/wholesale-stuff" />
  <input type="hidden" name="data[shop]" value="awesomeshop" />
  <div>
    <label for="gatekeeper-name">Name:</label>
    <input type="text" name="data[User][name]" id="gatekeeper-name" />
  </div>
  <div>
    <label for="gatekeeper-username">Username:</label>
    <input type="text" name="data[User][username]" id="gatekeeper-username" />
  </div>
  <div>
    <label for="gatekeeper-password">Password:</label>
    <input type="text" name="data[User][password]" id="gatekeeper-password" />
  </div>
  <div>
    <label for="gatekeeper-partner_code">Partner Code:</label>
    <input type="text" name="data[User][partner_code]" id="gatekeeper-partner_code" />
  </div>
  <div>
    <input type="submit" value="Create my account" />
  </div>
</form>