CHECK DRAFT AUTHORIZATION FORM

From:	Name/Login ID:	              ___________________________________
		Address:	      ___________________________________
		City, State, Zip:     ___________________________________
		E-mail:		      ___________________________________
		Telephone:	      ___________________________________
		4 letter ID           ___________________________________
					
To:		Interactive Creations Incorporated
1701 W. Northwest Highway, Suite 220
Grapevine, TX  76051

Dear Sir or Madam:

This document is used to certify that Interactive Creations Incorporated ("ICI") is authorized to draft my account for monthly payments relating to online simulations or other future offerings beginning on the date below.

I understand that there is a monthly processing charge of $2.00 for the use of the account draft.  I also agree to the terms and conditions of ICI's Terms of Service and the Pricing and Billing Policy, as updated.

The pre-authorized checks will be drawn on the account shown on the attached voided check below.

					Signature:	________________________

					Date:		________________________

	


 




Place a copy of the voided check here
[Do NOT send a deposit slip]





PLEASE MAIL THIS TO ICI AT THE ABOVE ADDRESS ASAP
TO ACTIVATE ACCOUNT SOONER, YOU MAY ALSO FAX IT TO 817-251-2228 (BUT ALSO MAIL ORIGINAL WITHIN 2 WEEKS)