21 CENTURY
ST
E TRAVEL
AFFILIATE AGREEMENT
FORM
! Affiliate Business System
USD$99 +
USD$15.00/month*
(ABS)
All Affiliate Applicants must purchase the software license to use the ABS. This on-line system includes a Website, a Back Office, Online Training Program
and access to Sales and Marketing Tools, and an Affiliate Welcome Kit. Includes a Travel Blog to utilise to grow your business.
APPLICANT INFORMATION
Full
Name:
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Birth: !!!!!!
Date of
CO APPLICANT IF APPLICABLE
Full
Name:
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Date of Birth: !!!!!!
BILLING ADDRESS: (NO PO BOX)
Address:
Suburb:
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COMPANY / ENTITY INFORMATION
Company:
Email:
Billing
Addre
ss:
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CREDIT CARD DETAILS
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Card Number:
?? Expiration Date on Card:
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Name on card:
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Signature:
Billing Address: 21st Century Education: Level 8, 100 Albert Road, South Melbourne VIC 3205
(This is billing provider on behalf of
21st Century E Network LLC)
IMPORTANT NOTICE TO THE CONSUMER
Applicant’s Signature:
Date:
Co - Applicant’s Signature:
Date:
INTERNAL USE ONLY: ENROLLER NAME:
21-05-15
BY JOINING YOU AGREE TO THE FOLLOWING TERMS AND CONDITIONS AND DISCLAIMERS: 1.BINDING EFFECT. (a) This is a binding agreement (the “Agreement”). By using the site at
www.21stCenturyETravel.com.au (the “Site”) or any materials or services provided in connection with the Site (the “Service”), you agree to abide by these Terms and Conditions, as they may
be amended by 21stCentury E Network, LLC. (“Company”) from time to time in its sole discretion. (b) YOU AGREE THAT BY USING THE SERVICE YOU REPRESENT THAT YOU ARE AT LEAST 18
YEARS OLD AND THAT YOU ARE LEGALLY ABLE TO ENTER INTO THIS AGREEMENT. (c) You agree to pay, and authorize automatic recurring billing of, the membership fee with your credit card,
or other payment methods, until subsequently cancelled. You understand and agree that each automatic recurring billing of the membership fee is not refundable and will not be prorated.
You authorise Company to initiate debit entries from the account provided and for the membership fee, as well as any other purchases made on the Site. (d) Company reserves the right to
change the membership fee from time to time. Read Full Terms Of Use. MONTHLY SUBSCRIPTION FEES If you purchase our products or services that are subscription based, you agree to pay,
and authorise automatic recurring billing of the subscription fee with your credit card, or other payment methods, until subsequently cancelled by you. Your account will be charged every 30
days. You understand and agree that each automatic recurring billing of the subscription fee is non-refundable and will not be prorated as the service is deemed used when accessed. You
authorise Company to initiate debit entries from the account provided for the subscription fee, as well as any other purchases made on the Site. You may cancel at anytime. Products that are
subscription based and charged monthly are: Basic System $15/month.
ENROLLER ID# OR USERNAME:
www.21stCenturyETravel.com.au
AUSTRALIA: L8, 100 Albert Road, South Melbourne, VIC 3205
Phone: 1800 999 270 International: +61 3 9975 7601 Fax: +61 3 8456 5973
Email: [email protected] www.21stCenturyETravel.com.au
SINGAPORE:
11th Floor, Wisma Atria 435 Orchard Road, Singapore, 238877
LOS ANGELES: Watt Plaza Business Center, 1875 Century Park East.
Suite 700 Century City CA 90067