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<html> <head> <title>Affiliate Program</title> </head> <center> <font face="verdana"><B>Affiliate Program</B> - <font color="#000099">Signup</fo nt></font><P><BR> <form method="post" action="signup.cgi?tab=complete"> <B><font face="verdana" size="-1" color="red"><!-- [error] --></font></B> <table width=60% border="0" cellspacing="0" cellpadding="0"> <tr> <td> <center> <table border="0" width=100% cellspacing="1" cellpadding="1" bgcolor="#000 000"> <tr> <td> <table border="0" width=100% cellspacing="0" cellpadding="3" bgcolor =#E0DCC0> <tr> <td colspan=2> <B><font face="verdana" size="1" color="#000099">Contact Infor mation</font></B> </td> </tr> <tr> <td><font face="verdana" size="1">Name:</font></td> <td><input type="text" name="name" size="24" value="[name]"></td > </tr> <tr> <td><font face="verdana" size="1">Make Checks out to:</font></td > <td><input type="text" name="checkname" size="24" value="[checkn ame]"></td> </tr> <tr> <td><font face="verdana" size="1">E-mail:</font></td> <td><input type="text" name="email" size="24" value="[email]"></ td> </tr> <tr> <td><font face="verdana" size="1">Street Address:</font></td> <td><input type="text" name="address1" size="24" value="[address 1]"></td> </tr> <tr> <td></td> <td><input type="text" name="address2" size="24" value="[address 2]"></td> </tr> <tr> <td><font face="verdana" size="1">City:</font></td> <td><input type="text" name="city" size="24" value="[city]"></td > </tr> <tr> <td><font face="verdana" size="1">State/Province:</font></td>

<td><input type="text" name="state" size="24" value="[state]"></ td> </tr> <tr> <td><font face="verdana" size="1">Zip:</font></td> <td><input type="text" name="zip" size="6" value="[zip]"></td> </tr> <tr> <td><font face="verdana" size="1">Country:</font></td> <td> <SELECT NAME="country" SIZE="1"><option SELECTED>[country]</option> <option>Afghanistan</option><option>Albania</option><option>Algeria</option><opt ion>American Samoa</option><option>Andorra</option><option>Angola</option><optio n>Anguilla</option><option>Antarctica</option><option>Antigua And Barbuda</optio n><option>Argentina</option><option>Armenia</option><option>Aruba</option><optio n>Australia</option><option>Austria</option><option>Azerbaijan</option><option>B ahamas</option><option>Bahrain</option><option>Bangladesh</option><option>Barbad os</option><option>Belarus</option><option>Belgium</option><option>Belize</optio n><option>Benin</option><option>Bermuda</option><option>Bhutan</option><option>B olivia</option><option>Bosnia And Herzegowina</option><option>Botswana</option>< option>Bouvet Island</option><option>Brazil</option><option>British Indian Ocean Territory</option><option>Brunei Darussalam</option><option>Bulgaria</option><o ption>Burkina Faso</option><option>Burundi</option><option>Cambodia</option><opt ion>Cameroon</option><option>Canada</option><option>Cape Verde</option><option>C ayman Islands</option><option>Central African Republic</option><option>Chad</opt ion><option>Chile</option><option>China</option><option>Christmas Island</option ><option>Cocos (Keeling) Islands</option><option>Colombia</option><option>Comoro s</option><option>Congo</option><option>Congo, The Democratic Republic Of The</o ption><option>Cook Islands</option><option>Costa Rica</option><option>Cote D'ivo ire</option><option>Croatia (Local Name: Hrvatska)</option><option>Cuba</option> <option>Cyprus</option><option>Czech Republic</option><option>Denmark</option><o ption>Djibouti</option><option>Dominica</option><option>Dominican Republic</opti on><option>East Timor</option><option>Ecuador</option><option>Egypt</option><opt ion>El Salvador</option><option>Equatorial Guinea</option><option>Eritrea</optio n><option>Estonia</option><option>Ethiopia</option><option>Falkland Islands (Mal vinas)</option><option>Faroe Islands</option><option>Fiji</option><option>Finlan d</option><option>France</option><option>France, Metropolitan</option><option>Fr ench Guiana</option><option>French Polynesia</option><option>French Southern Ter ritories</option><option>Gabon</option><option>Gambia</option><option>Georgia</o ption><option>Germany</option><option>Ghana</option><option>Gibraltar</option><o ption>Greece</option><option>Greenland</option><option>Grenada</option><option>G uadeloupe</option><option>Guam</option><option>Guatemala</option><option>Guinea< /option><option>Guinea-bissau</option><option>Guyana</option><option>Haiti</opti on><option>Heard And Mc Donald Islands</option><option>Holy See (Vatican City St ate)</option><option>Honduras</option><option>Hong Kong</option><option>Hungary< /option><option>Iceland</option><option>India</option><option>Indonesia</option> <option>Iran (Islamic Republic Of)</option><option>Iraq</option><option>Ireland< /option><option>Israel</option><option>Italy</option><option>Jamaica</option><op tion>Japan</option><option>Jordan</option><option>Kazakhstan</option><option>Ken ya</option><option>Kiribati</option><option>Korea, Democratic People's Republic Of</option><option>Korea, Republic Of</option><option>Kuwait</option><option>Kyr gyzstan</option><option>Lao People's Democratic Republic</option><option>Latvia< /option><option>Lebanon</option><option>Lesotho</option><option>Liberia</option> <option>Libyan Arab Jamahiriya</option><option>Liechtenstein</option><option>Lit huania</option><option>Luxembourg</option><option>Macau</option><option>Macedoni a, The Former Yugo-slav Republic Of</option><option>Madagascar</option><option>M alawi</option><option>Malaysia</option><option>Maldives</option><option>Mali</op tion><option>Malta</option><option>Marshall Islands</option><option>Martinique</ option><option>Mauritania</option><option>Mauritius</option><option>Mayotte</opt ion><option>Mexico</option><option>Micronesia, Federated States Of</option><opti

on>Moldova, Republic Of</option><option>Monaco</option><option>Mongolia</option> <option>Montserrat</option><option>Morocco</option><option>Mozambique</option><o ption>Myanmar</option><option>Namibia</option><option>Nauru</option><option>Nepa l</option><option>Netherlands Antilles</option><option>Netherlands</option><opti on>New Caledonia</option><option>New Zealand</option><option>Nicaragua</option>< option>Niger</option><option>Nigeria</option><option>Niue</option><option>Norfol k Island</option><option>Northern Mariana Islands</option><option>Norway</option ><option>Oman</option><option>Pakistan</option><option>Palau</option><option>Pan ama</option><option>Papua New Guinea</option><option>Paraguay</option><option>Pe ru</option><option>Philippines</option><option>Pitcairn</option><option>Poland</ option><option>Portugal</option><option>Puerto Rico</option><option>Qatar</optio n><option>Reunion</option><option>Romania</option><option>Russian Federation</op tion><option>Rwanda</option><option>Saint Kitts And Nevis</option><option>Saint Lucia</option><option>Saint Vincent And The Grena-dines</option><option>Samoa</o ption><option>San Marino</option><option>Sao Tome And Principe</option><option>S audi Arabia</option><option>Senegal</option><option>Seychelles</option><option>S ierra Leone</option><option>Singapore</option><option>Slovakia (Slovak Republic) </option><option>Slovenia</option><option>Solomon Islands</option><option>Somali a</option><option>South Georgia And The South Sandwich Islands</option><option>S outh Africa</option><option>Spain</option><option>Sri Lanka</option><option>St. Pierre And Miquelon</option><option>St. Helena</option><option>Sudan</option><op tion>Suriname</option><option>Svalbard And Jan Mayen Islands</option><option>Swa ziland</option><option>Sweden</option><option>Switzerland</option><option>Syrian Arab Republic</option><option>Taiwan, Province Of China</option><option>Tajikis tan</option><option>Tanzania, United Republic Of</option><option>Thailand</optio n><option>Togo</option><option>Tokelau</option><option>Tonga</option><option>Tri nidad And Tobago</option><option>Tunisia</option><option>Turkey</option><option> Turkmenistan</option><option>Turks And Caicos Islands</option><option>Tuvalu</op tion><option>Uganda</option><option>Ukraine</option><option>United Arab Emirates </option><option>United Kingdom</option><option>United States</option><option>Un ited States Minor Outlying Islands</option><option>Uruguay</option><option>Uzbek istan</option><option>Vanuatu</option><option>Venezuela</option><option>Viet Nam </option><option>Virgin Islands (British)</option><option>Virgin Islands (U.S.)< /option><option>Wallis And Futuna Islands</option><option>Western Sahara</option ><option>Yemen</option><option>Yugoslavia</option><option>Zambia</option><option >Zimbabwe</option> </td> </tr> <tr> <td><font face="verdana" size="1">Phone:</font></td> <td><input type="text" name="phone" size="24" value="[phone]"></ td> </tr> <tr> <td colspan=2> &nbsp;<BR><B><font face="verdana" size="1" color="#000099">Sit e Information</font></B> </td> </tr> <tr> <td><font face="verdana" size="1">Site Title:</font></td> <td><input type="text" name="sitetitle" size="45" value="[siteti tle]"></td> </tr> <tr> <td><font face="verdana" size="1">Site URL:</font></td> <td><input type="text" name="siteurl" size="45" value="[siteurl] "></td> </tr> <tr>

<td><font face="verdana" size="1">Site Category:</font></td> <td><SELECT NAME="category" SIZE="1"><option SELECTED>[category] </option><option>Personal</option><option>Business Services/Products</option><op tion>Index Directory</option><option>Retail/Consumer Goods</option><option>Non-P rofit</option><option>Entertainment</option><option>Other</option></td> </tr> <tr> <td><font face="verdana" size="1">Amount of Unique Hits per Mont h:</font></td> <td><input type="text" name="hits" size="10" value="[hits]"></td > </tr> <tr> <td colspan=2> &nbsp;<BR><B><font face="verdana" size="1" color="#000099">Log in Information</font></B> </td> </tr> <tr> <td><font face="verdana" size="1">Username:</font></td> <td><input type="text" name="username" size="12" maxlength="12" value="[username]"> <font face="verdana" size="1">(must be 5 - 12 characters)</f ont></td> </tr> <tr> <td><font face="verdana" size="1">Password:</font></td> <td><input type="password" name="password" size="12" maxlength=" 12" value="[password]"> <font face="verdana" size="1">(must be 5 - 12 characters )</font></td> </tr> <tr> <td colspan=2> &nbsp;<BR><B><font face="verdana" size="1" color="#000099">Ter ms and Conditions</font></B> </td> </tr> <tr> <td colspan=2> <font face="verdana" size="1"><TEXTAREA COLS=70 ROWS=15 READON LY WRAP=SOFT> 1. Affiliate Code Presentation The code we supply you may not be modified in any way including a size change or any graphical changes as well. 2. Our Rights We reserve the right to reject any affiliate application that they wish and can terminate an existing affiliates account without prior notice. We also hold the right to change aspects of the terms and conditions of our affiliate program and the properies surrounding the program, such as the commission percentage. 3. Affiliate's Rights Affiates have the right to recieve their checks promptly and on time on a regula r basis provided that their commission total exceeds the minimum. Affiliates als o have the right to receive the proper amount of money that is owed to them acco rding to their statistics page. Finally, affiliates have the right to discontinu e their account at anytime. 4. Disclaimer You hereby agree to indemnify and hold us harmless against any and all claims, a ctions, demands, liabilities, losses, damages, judgments, settlements, costs, an

d expenses (including reasonable attorneys' fees) (any or all of the foregoing h ereinafter referred to as "Losses") insofar as such Losses. 5. Terms of Agreement By signing up for our Affiliate program you agree with every statement on this p age. This agreement holds true for as long as you are a member of the program an d you may only receive commissions when you account is still active. Any violati ons of this agreement will result in the termination of your account and the hol ding of all your earned money. 6. Frauds and Scams Anyone who using any technique to try and unfairly make money through our Affili ate Program will have their account immediately terminated and a lawsuit may be pressed against the guilty parties. </TEXTAREA> </td> </tr> <tr> <td colspan=2> <font face="verdana" size="1"><input type="checkbox" name="ter ms"> I have read and agreed to the above terms and conditions </td> </tr> </table> </td> </tr> </table> <BR> </center><input type=submit value="Signup"> </td> </tr> </table> </form> </center> </BODY> </HTML>

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