(* = required field)
Store Name	*
Affiliate Username	*
Address1	*
Address2
City	*
State	*
ZIP	*
Website	*	(ex. http://www.yourstore.com)
Name:	*
Title:	*
Phone	*
Email	*
Date:	*
Billing Option:	*	Choose One I will enter my credit card for each order. I will use a Purchase Order Number - Keep my card on file and charge each purchase.

Hereinafter referred to as COMPANY.

Whereas ENGRAVER has developed the REMOTE ENGRAVING SOLUTION referred to hereinafter as the PLAN, and COMPANY desires to participate in such program, the parties agree as follows:

A.       INITIAL SETUP

  1.   COMPANY shall purchase one, or more, of ENGRAVER's displays as described in exhibit A and place it prominently in COMPANY's retail outlet.  Purchase shall be made at prices published by ENGRAVER, as shown in exhibit A, which is subject to amendment from time to time.

  2.      COMPANY shall apply online at ENGRAVER’s website located at http://www.medicassist.net and create an affiliate account. COMPANY shall choose an affiliate link graphic for COMPANY’s use.

  3.      COMPANY shall show ENGRAVER's products on COMPANY’s web site and/or, apply the affiliate link graphic to ENGRAVER's web site on COMPANY’s web site.

  4.      As COMPANY’s customers purchase products of ENGRAVER's line, shown in exhibit A, which is subject to amendment from time to time, COMPANY shall enter these orders on ENGRAVER’s website at http://www.medicassist.net in accordance with the PLAN. 

  5.      In order to receive the benefit of the plan discount, COMPANY must use the unique token number at checkout that shall be assigned to COMPANY by ENGRAVER.  Such token number remains the property of ENGRAVER at all times and COMPANY must stop any use of such token number at any time that this agreement is cancelled by either party.

   6.      All orders placed through the ENGRAVER’s web site shall be processed in real time with COMPANY’s credit card, or as otherwise described in the PLAN and indicated above.

   7.      ENGRAVER shall notify COMPANY of any changes in exhibit A in a timely manner.

   9.      ENGRAVER shall create a unique entry page to ENGRAVER’s website for COMPANY’s use in entering orders.  COMPANY agrees to use this unique entry page for all order processing.

  10.    Engraver reserves the right to disallow this application.

  11.    This agreement may be cancelled by either party at any time.

By pressing the "SUBMIT" button I represent
that I am authorized to enter into this agreement,
agree with the terms of this agreement as written,
 and wish to become a Commercial Affiliate Store under the terms
of the Remote Engraving Solution.