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PrivateList Coupon Enrollment Form                Date:

Print and fill out two copies of this form. Keep one; mail the other to:

                    PrivateList
                    22A Wedgewood Drive
                    Antigonish, Nova Scotia    B2G 1J3

Company Information
 
Company Name: _____________________________________________________

Full Address: ________________________________________________________

E-mail address: ______________________________________________________

Contact name and phone: _______________________________________________



Coupon Details

(These details will appear on your coupon: fill in the first four items only if they differ from those in the "Company Information" section, above. The Company Message can be a statement indicating how long you’ve been in business, an itemized list of various services offered, etc. The Coupon Offer is a concise statement of the benefits the customer will receive by turning in the coupon.)

Company Name:  _____________________________________________________

Phone: _________________     E-mail address: ______________________________

Full Address: _________________________________________________________
 
Web-Site Address (if any): _______________________________________________

Company Message: ___________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

Coupon Offer: _______________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

Start date: ____________________ 6-month Expiry date ____________________
 
 

Agreement

I hereby confirm my participation in the PrivateList Partners program, which provides visitors to www.privatelist.com with coupons for services (like my own) related to their private real-estate purchase or sale.

The following rights, conditions and obligations apply:

  • I agree to acquaint any contacts I may happen across, who are or will be in the process of selling their real property, with the web-site www.privatelist.com, and to display and/or pass along to them any materials (business cards, brochures, etc.) provided me from time to time by PrivateList for that purpose;
     
  • I accept sole responsibility for the accuracy of the information presented on the coupon, and undertake to fulfill the obligations it describes, at any time up to and including the expiry date indicated;
     
  • PrivateList retains the right to cancel this agreement at any time and for any reason;
     
  • I may cancel display of the coupon at any time or alter the coupon’s terms, but agree to honour the original terms of any coupons redeemed subsequent to such cancellation or amendement but prior to the original coupon’s noted expiry date;
     
  • During the term of the trial, I am entitled to four amendements of the coupon (if required) at no charge;
     
  • PrivateList promises that every effort will be made to provide continuous display of the coupon described above for the agreed period, but will be held blameless for any and all damages resulting from circumstances beyond its control (such as problems with the internet itself) which may, from time to time, temporarily interrupt such exposure.



Signed: ________________________ for (company) _________________________