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Monster Media 1994 #2
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Monster Media No. 2 (Monster Media)(1994).ISO
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JOINPWS.DOC
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1994-04-22
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PERSONAL WEALTH SUBSCRIBER Application and Agreement Form
Print or type all information clearly and accurately. Please make
a copy for your files. Send a copy to your sponsor. Send originals
to PWS at: 8535 Baymeadows Road, Suite 25, Jacksonville, FL 32256
1. NEW SUBSCRIBER INFORMATION:
Today's Date _______/_______/_______
Date of Birth _______/_______/_______
Name(Last, First, Middle Initial)
_________________________________________________________________
City ________________________________ State __________________
Zip Code ___________________________
Social Security Number __ __ __- __ __ - __ __ __ or Federal I. D.
Number __ __ - __ __ __ __ __ __ __
2. SPONSOR INFORMATION
Name Information Innovations, Inc., Dr. Jeffrey Lant's Elite
Group: 88-0282488.
3. SUBSCRIBER AGREEMENT
Yes! Enroll me as a PWS Subscriber! I agree to pay $59 initiation
fee and $49 each month (plus state sales tax, if applicable)
thereafter beginning with my first full business month (business
month runs from the 16th to the 15th). I am of legal age in my
state of residency. I understand that I'm entitled to the benefits
described in company material, and I will abide by the policies and
procedures of PWS, Inc. Subscribers may not obtain price quotes or
merchandise for non-subscribers. See important cancellation notice
on the bottom of this form.
SIGNATURE:
X__________________________________________________
Date _______ / ______ / _______
4. SUBSCRIBER TERMS
1. I am the age of majority. 2. By signing this agreement form, I
certify that I have read, understand and agree that I will comply
with said terms, conditions, all policies, procedures and any
subsequent modifications thereto. 3. PWS, Inc. is not a discount
buying club. PWS, Inc. works with selected product and service
suppliers who offer their prices to PWS subscribers, which may or
may not be the lowest possible price available. 4. PWS, Inc. will
terminate any subscriber agreement following written notice of
same. 5. I will pay PWS, Inc. the required subscription fee on a
timely basis. 6. This agreement will become effective only after
it has been received and accepted by PWS, Inc. 7. Subscription
Fee: $59 initiation fee. The annual renewal fee of $15 (beginning
second year) and $49 per month as long as subscription remains in
force.
5. DESIRED PAYMENT OPTION
[ ] I wish to pay quarterly. I have enclosed $159. Billed me
every 3 months.
[ ] I wish to pay semi-annually. I have enclosed $304. Bill me
every 6 months.
[ ] I wish to pay annually. I have enclosed $598. Bill me
annually.
Above payment include initial $59 initiation fee.
Important Note: Quarterly, semi-annual, or annual payments can be
made by check, money order or credit card (VISA, Master Card or
American Express). PWS will bill you directly prior to renewal
date thereafter.
Cancellation Rights: You may cancel your subscription without
penalty or obligation within three (3) business days from the date
of this application (Alaska residences, 5 days). In such event,
all payments made by you under this agreement, and/or any
negotiable instrument executed by you, will be returned within ten
(10) business days following receipt of your written notice to
rescind, and this transaction will be cancelled. After the initial
month, you may give notice to cancel your subscription at any time,
and your cancellation shall be effective on the last day of the
business month in which your written notice of cancellation is
received by us. Any prepayments which may apply, as in the case of
those paying quarterly or semiannually will be refunded to you
within ten (10) business days following our receipt of written
notice. All notices must be in writing and sent to Personal Wealth
Systems by certified mail.
PWS Subscriber Application
(Note: Sections 6 & 7 to be filled out by credit card and
electronic transfer of funds users only. If you are paying
quarterly, semi-annually or annually, simply disregard section 6 &
7)
6. CREDIT CARD INFORMATION
[ ] $59 initiation fee and $49 each month thereafter beginning with
my first full business month and until PWS, Inc. is in receipt of
my written notice to cancel. See bottom, left side of this
application for cancellation details.
[ ] $157 initial quarterly payment. I understand that I will be
billed every three months thereafter.
[ ] VISA [ ] MasterCard [ ] American Express
Today's Date ____/____/____
Card Number ____________________________________________
Expiration Date _______/_______/________
Name on Card ______________________________________
Signature _________________________________________
(To sign up the same day see special note # 8 for fax information)
7. ELECTRONIC FUNDS TRANSFER
Enclosed find my personal check for $59 (initiation fee) and one
blank check marked "VOID" for Electronic Funds Transfer.
Authorization Agreement for Pre-authorized Payments to Personal
Wealth Systems: I (we) hereby authorized Personal Wealth Systems to
initiate debit entries to my (our) checking account indicated below
in the amount of FORTY NINE DOLLARS ($49) each month and authorize
my bank named below to debit the same to my account.
My Bank's Name _______________________________________________
Bank Address _________________________________________________
City _____________________________________
State ______________________ Zip Code ____________________
Account # _____________________________
Authorized Signature ___________________________________________
This authorization is to remain in full force until such time that
Personal Wealth Systems and my bank named above have received
written notification by certified mail from me as to my intent to
cancel this agreement. I understand this agreement must be
cancelled as outlined above by the 10th day of the month in order
to stop the auto-draft for the following month. If not cancelled
by the 10th day of the month, PWS has the right to draft my account
after the 16th of the month without recourse. I agree that signing
this authorization is as binding on me as if I had personally
written checks to Personal Wealth Systems, and if an auto-draft
against my checking account is not honored, then I will be held
responsible and liable for the amount of such draft plus service
charges.
Print Name __________________________________________
Social Security Number:
_____ _____ _____ - _____ _____ - _____ - _____ _____ _____
Signature:
X__________________________________________________
(You must enclose a voided check in order to process this
application if you are using electronic funds transfer as your
method of payment.) For Bank Use Only: Indemnification Agreement.
To the bank addressed: In consideration of your honoring
pre-authorized checks or electronic transfers drawn against
depositors of your bank for the payment of membership fees to
Personal Wealth Systems, Inc., we agree that no liability or
responsibility for contract lapses or otherwise shall attach to
your bank as a result of honoring such checks or electronic
transfers, and we further agree to hold you harmless from and
reimburse you for any loss resulting as a consequence of your
participation pursuant to your agreement to honor such checks or
electronic transfers. We shall defend any action brought against
you by any of your depositors or any other person because of your
compliance with this Pre-authorized Check Plan for collecting dues.
8. SPECIAL NOTE
* Welcome Kits are shipped within 2 to 3 business days of receipt
and acceptance of new applications by PWS, Inc. at its home office
in Jacksonville, Florida. Welcome Kits are shipped via 2nd day
UPS.
* If you are paying by credit card you can fax your application
directly to PWS headquarters at (904) 730-8706
PERSONAL WEALTH CONSULTANT
Application and Agreement Form
Print or type all information clearly and accurately. Please make
a copy for your files. Send a copy to your sponsor. Send originals
to: PWS 8535-25 Baymeadows Road, Jacksonville, Florida 32256
1. New Consultant Information
Today's Date _______/______/______
Date of Birth ______/______/______
Name (Last, First, Middle Initial)
_________________________________________________________________
Street Address (No P.O. Boxes)
_________________________________________________________________
City __________________________________________ State ___________
Zip Code _____________
Social Security Number:
_____ _____ _____ - _____ _____ - _____ - _____ _____ _____
or Federal I.D. Number:
_____ _____ - _____ _____ _____ _____ _____ _____ _____
Daytime Phone Number (_______) ___________________________________
Evening Phone Number (_______) ___________________________________
2. Sponsor Information
Name __________________________________________________ (JL)
Social Security Number:
_____ _____ _____ - _____ _____ - _____ _____ _____ _____
or Federal I. D. Number
_____ _____ - _____ _____ _____ _____ _____ _____ _____
3. Consultant Agreement
Yes! Enroll me as a PWS Consultant! As a Personal Wealth
Consultant I agree to abide by the policies and procedures of PWS,
Inc. Said policies and procedures may be changed from time to
time, and I agree to be bound by them as revised. I fully
understand that no purchase of a subscription or payment is
required to become or remain a PWS Consultant. I have read and
agree to the PWS, Inc. Consultant Terms as stipulated below.
SIGNATURE:
X__________________________________________________________
Date _____/_____/_____
4. Consultant Terms
1. I understand and agree that as a Consultant I will not be
treated as an employee with respect to such services for Federal or
State tax purposes. 2. By signing this agreement form I certify I
understand and agree that I will comply with said terms,
conditions, all policies and procedures and any subsequent
modifications thereto. 3. I acknowledge that being a Consultant
does not require any fees or purchases, nor will it constitute the
sale of a franchise or distributorship. I agree to make no
contrary representation or statement in sponsoring other
Consultants. 4. This agreement shall be governed by the laws of
the state of Florida and all claims, disputes and other matters
between the parties of this agreement shall be brought in District
Court, in Jacksonville, or in the U.S. District Court,
Jacksonville, Duval County, FL. 5. I am of legal age in the state
in which I enter this agreement. 6. I am obligated to fulfill a
bonafide supervisory and selling function in the sale of products
and subscriptions to the ultimate retail consumer and in the
training and assistance to those Consultants I sponsor. 7. I agree
not to use the company trade name and/or logo or trademark except
in the advertising provided to me by the company, or in other
advertising without prior written approval by the company. 8.
Consultants may return literature and sales aids in reusable and
resalable condition at any time within 60 days of purchase and
receive 100% refund. Shipping cost on returns shall be borne by
Consultant. PWS, Inc. will honor refund policies provided by any
state or federal law applicable to the Consultant (New Mexico,
one-year; GA, LA, WY, MO, MA, no time limitation). 9. A Consultant
may not have more than one PWS position and may not solicit PWS
Consultants (other than personally enrolled PWS Subscribers or
Consultants) for other direct marketing programs. 10. Consultant
agrees to abide by these terms and all other policies and
procedures provided by PWS, Inc., which are hereby incorporated by
reference upon delivery. 11 Federal or state regulatory agencies
do not approve or endorse direct marketing programs. Therefore,
Consultants may not represent that the company program has been
approved or endorsed by any governmental agency.
How to cancel as a Consultant: You may cancel your participation as
a Consultant at any time, regardless of reason, by sending written
notice, signed and notarized, to Personal Wealth Systems by
certified mail. All notices of cancellation must be sent to:
Personal Wealth Systems, Inc. at 8535-25 Baymeadows Road,
Jacksonville, FL 32256.
END OF JOINPWS.DOC
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