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__ I
elect to become a Net Rep. Attached
with this application is payment of a refundable deposit of $60.00. As
a Net Rep I will receive all of the benefits and rights associated with
Net Rep status as described in the Policies and Procedures and in the Marketing
and Compensation Plan. I understand that as a Net Rep I will be charged
if I choose to receive specific optional services which are included in
the optional Distributor program. These optional services are not required
for me to successfully perform my duties as a Representative.
___ I elect to be chargedthe
additional monthly fee of $ 15.95 for access to the FlashNet Opportunity
website which, among other services, will allow me to sign customers up
on-line. I understand that this service will be billed monthly to my credit
card listed below and is not available without using a credit card for
such charges. I understand that this fee would not be charged if I elected
to become a Distributor.
__ I elect
the optional Distributor program. Attached
with this application is payment of a non-refundable fee of $199.00 for
my Initial year of participation as a Distributor. As a Distributor I will
receive all of the benefits and rights associated with Distributor status
as described in the Policies and Procedures and in the Marketing and Compensation
Plan.
Payment is made by: Attached
Check #_________, or by one of the following Credit Cards:
American
Express VISA MasterCard Discover
(check one)
Card
#: __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ Exp. Date ____/____/____
Name as
shown on Card: __________________________________________________
Assumed Names, Corporations,
Partnerships, or Trusts-- If
your Representative business will be owned by a corporation,partnership
or trust, or will be operated under an assumed name ( e.g., XYZ Enterprises
or John Doe and Associates), you must complete FlashNet's Entity Form and
submit it with this Application and Agreement.
By
signing below, I apply to become a FlashNet Representative. I certify that
I am of legal age (the age of majority) for the state in which I reside.
I have carefully read the terms and conditions on the back of this application
and agree to abide by them. I understand that I have the right to terminate
my Representative business at any time, with or without reason. I agree
that such termination must be in writing. I agree to the charges shown
above being applied to my credit card.
X
X___________________________________
Applicant's
Signature
Co-Applicant's Signature
Date: ____/____/____
Date: ____/____/____
Please fax this completed Application
and Agreement to FlashNet to obtain a Rep ID#. You must mail the completed
signed original Application and Agreement to: FlashNet,
Representative Application Dept., 1812 North Forest Park Boulevard, Fort
Worth, Texas 76102.
Promotion qualifications are
not valid and no commission or bonus checks will be sent to the applicant
until FlashNet receives the signed original Application and Agreement.
If the original Application and Agreement is not received by FlashNet within
thirty days of the date on which it is faxed, This Agreement shall automatically
terminate. Your canceled check or credit card charge, and your first monthly
bonus report constitute your receipt and verification that your Application
has been accepted by FlashNet.
*
By entering my Social Security (or Federal Tax Identification Number, if
applicable) on this Representative Application and Agreement, I certify
that this number is my correct taxpayer identification number. I have not
been a FlashNet Representative, or a partner, shareholder, or principal
of any entity having an FlashNet Representative business within the past
six months. I understand that any intentional misrepresentation of any
information I provide on this Representative Application and Agreement
may result in action by FlashNet, up to and including terminationof this
Agreement.
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1 Copy - Applicant
1 Copy - Sponsor |