FUTURESCOPE MARKETING

INDEPENDENT CONSULTANTS

PLEASE PRINT THIS FORM AND MAIL OR FAX IT TO: (510) 763-2464.
Method of Payment: (Circle One)
Personal Check Money Order Cashier's Check VISA MasterCard

Name________________________________________________________________________________

Phone (____)____________________________________ Fax (______) ___________________________

Mailing Address_________________________________________________________________________

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________________________________________________________________Zip ___________________

E-mail Address______________________________ Social Security No _____________________________

Credit Card No.______________________________________________Expiration_________/__________

Name as it appears on the card______________________________________________________________

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Date__________________________________

DISCLAMER NOTICE.

Please note, the above is not an offer of employment, all Independent consultants work entirely on their own using a chosen proprietory or company business name. As such Independent consultants are not allowed to mention Futurescope Marketing as their employer during the course of selling any of our advertising mediums or products unless authorised. Futurescope Marketing Int'l, Inc. does not accept any responsibility whatsoever for misdemeanors of any kind commited by an Independent consultant. Advertisers are very welcome to check with us anytime to confirm placement of advertistments by their Independent Consultants.

Please return to: Futurescope Marketing Int'l, Inc 41 Sutter Street, Suite #1319, San Francisco, CA 94104
Phone: (510) 763 2464 Fax (510) 763 2464


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