ASI Canada Distributor Membership Application

Advertising Specialty Institute®

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ASI Member Benefits For You

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Thank you for your interest in becoming a distributor member of the Advertising Specialty Institute (ASI). Here are just some of the benefits you’ll receive with your membership.

In order to qualify for ASI Canada distributor membership, your distributorship must be …• An active, for-profit entity in Canada. • Doing business in the ad specialty industry or any related industry.• Purchasing the majority of your ad specialties from suppliers and /or manufacturers for resale to end-user customers that are not owned, operated,

controlled, franchised, affiliated or connected to your distributorship/company.

To become one of our 20,000+ successful distributor members just complete the following three steps …1. Complete this application along with payment information.2. Submit copies of invoices from at least three different ASI suppliers addressed to your company, each over $100, and dated from within the

last twelve months. These invoices must be for ad specialties, but not purchased for use by your company or any entity affiliated with yourcompany. Please include the end-user clients’ name, city and state on each invoice. We do not use the information you provide to contactyour clients. This will help establish your company’s credit profile, allowing you to place orders more quickly with ASI suppliers.

3. Fax your application along with proper invoices to ASI Membership at 1-800-546-1269.

Upon completion of the above steps, ASI will process your information and notify you within a week with your ASI number.

If you have any questions about ASI, please call 1-800-546-1232 or email membership@asicentral.com.We look forward to working with you to grow your business.

asicentral.ca

QUARTERLY

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Section 1: Company Information

1. Company Name:

2. Bill to Address (P O Box)

City: Province: Postal code:

2a. Phone Number:

2b. Toll Free Number:

2c. Fax Number:

2d. Web Address:

2e. Primary Email:

3. Ship to Address

4. Primary Contact Information:

Name

Title

Email

Phone Number

Previous Employer

5. How did you hear about ASI:

nn Direct mail, email or Fax (Promotion Code )

nn Magazine Ad (Please name )

nn Internet (Search engine used )

nn Association (Please name )

nn Trade show (Please name )

nn Distributor/Supplier (Name & ASI # )

6. Check category that best describes your company:nn Individual proprietorship nn partnership nn Corporation nn LLC

7. What is your Primary location?nn Showroom nn Plant nn Office Building nn Residence nn Office/Showroom

8. Office Hours: Daily: to Saturday: to

9. In what year was your company established?

10. Is your business incorporated? nn Yes nn NoIf Yes, What was the date of incorporation?

What is the province of incorporation?

11. Is your firm a member of a trade association? ___Yes ___ NoIf Yes, Please provide name and acronym of the trade association:

Company/Owner Characteristics 12. Is your company minority owned? __ Yes __ No

13. Is your company owned by a ____Male ____ Female

14. Is your company a home based business? __ Yes __ No

15. Is your company family owned? ___ Yes ___ No

16. Approximate year of birth of firm owner/president _______

Sales Force17. Total Number of Employees:

18. Number of Employee Salespeople:Full time Part Time

19. Number of Independent Contractors:Full time Part Time

20. Gender of Sales Force: % Male: % Female

Sales Volume21. Sales of Advertising Specialty products only:

22. Total sales volume of the firm (including figure above):

23. Estimated Net Worth (Assets minus Liabilities) $

Section 2: References

The following information will bepublished in ASI Credit Connect,which provides distributor creditdata to ASI suppliers.

24. Bank Name:

City: Province:

Phone Number:

Supplier References25. Please list 3 suppliers within the ASI network that you have orderedfrom in the past year

Company Name: ASI #

Company Name: ASI #

Company Name: ASI #

Section 3: Company Services

Industry Characteristics:The following information may be used by our Editorial staff to gather indus-try trends and/or by ASI’s Credit Connect services that help suppliers markettheir products/services.

Special Services:26. Special services and facilities you offerto your clients include: (select up to 5)A nn Art, design and layoutB nn Copywriting for letters, brochures, etcC nn Complete advertising agency servicesD nn Complete sales promotion agency servicesE nn Specialty and premium fulfillment servicesF nn Warehousing and drop shippingG nn Direct mail list rental & maintenanceH nn PrintingI nn Gift wrapping/packagingJ nn Local imprinting and/or personalizing

Types of Operations27. List the key operations of your company: (select up to 5)

A nn Distributor of advertising specialtiesB nn Distributor of business giftsC nn Distributor of CalendarsD nn Distributor of Premiums/incentivesE nn ExporterF nn Manufacturers representativeG nn Distributor agentH nn Imprinter/screen printerI nn ImporterJ nn AssemblerK nn ManufacturerL nn Retailer of giftsM nn Retailer of stationeryN nn Wholesaler of stationeryO nn Wholesaler of general merchandiseP nn Printer

Q nn Advertising AgencyR nn Point of PurchaseS nn Specialty SupplierT nn Travel AgencyU nn FundraisingV nn Distributor of trophies/awardsW nn Distributor of business formsX nn Corporate co-op catalog producerY nn Distributor of Office

supplies/Office productsZ nn Embroider1 nn Fulfillment/Warehousing/

Drop shipping2 nn Mail list rental/Mail house3 nn Web site developer

Types of Accounts28. List the types of accounts your company sells to commonly: (select up to 5)A. nn Agriculture & FarmingB. nn Clubs, Associates, Civic Groups, Non ProfitsC. nn Financial (banks, S&L, credit unions)D. nn Government agenciesE nn Schools, colleges, universities, etc.F. nn Insurance companies and agenciesG. nn UtilitiesH. nn Industrial ProductsI. nn Clothing, Appliances, Soft goods, MfgsJ. nn Food, Tobacco, SundriesK. nn Chemical and Pharmaceutical companiesL. nn Political parties and candidatesM.nn Retail (stores, shopping centers)N. nn Professional Offices (Lawyers, Doctors)O.nn Marketing Services (ad agencies)P. nn Service businesses (real estate, personnel)Q.nn Transportation (Airlines, Freight companies)R. nn WholesalersS. nn Construction companiesT. nn Health and MedicalU. nn Recreation (Theaters, Bowling, etc)V. nn Automotive dealers & Mfgs.W.nn Hospitality (resorts, hotels, restaurants, etc)X. nn ManufacturingY. nn Media (Radio, TV, Newspapers, Magazines)Z. nn Sports Related (Professional Teams)1. nn Technology (Computers, Software Mfgs/Internet, Web Developers)

Product Lines29. List the main product lines of your company: (select up to 5)A nn Auto AccessoriesB nn Awards, Trophies & PlaquesC nn Badges, ButtonsD nn Calendars and timepiecesE nn Plastic (non-vinyl)F nn Food, EdiblesG nn Emblematic jewelryH nn Industrial and safety itemsI nn Glass and ceramic products (crystal)J nn Housewares and home products (flashlights, cutlery, etc)K nn Inflatables (balloons, etc)L nn Electronic/computer productsM nn Office and desk productsN nn Paper products (Pocket reminders, diaries)O nn Cards (business, greeting and stationery), Signs & displaysP nn Sports Accessories (Bottles, coolers, equipment, golf balls, etc)Q nn Toys & stuffed AnimalsR nn Vinyl (pocket, desk, home)S nn Wearables (Caps, jackets, shirts, etc)T nn Writing instrumentsU nn Key tagsV nn Health, safety and environmental productsW nn Travel productsX nn Magnetic productsY nn Cups and mugsZ nn Decals, transfers, emblems1 nn Bags (Canvas, Tote, Paper, Plastic, etc)2 nn Umbrellas/sunglasses3 nn Party Products (Balloons, Napkins, Plates, etc)4 nn Personal Care, Beauty Products5 nn Phone calling cards

30. Multiple Branch Locations – If you have multiple branches, please listtheir locations here. Use additional sheets if necessary.

Name:

Address:

City: Province: Postal code:

Contact name:

Title:

Email Address:

Phone Number: Fax Number:

Name:

Address:

City: Province: Postal code:

Contact name:

Title:

Email Address:

Phone Number: Fax Number:

Name:

Address:

City: Province: Postal code:

Contact name:

Title:

Email Address:

Phone Number: Fax Number:

Company Contacts:31. Marketing Contact

Name

Title

Email Phone Number

Primary Employer

Secondary:Name

Title

Email Phone Number

Primary Employer

Secondary: Name

Title

Email Phone Number

Company name of Prior Business or Employer

Secondary: Name

Title

Email Phone Number

Company name of Prior Business or Employer

Secondary: Name

Title

Email Phone Number

Company name of Prior Business or Employer

Secondary: Name

Title

Email Phone Number

Company name of Prior Business or Employer

Advertising Specialty Institute® • 4800 Street Road • Trevose, PA 19053-6698 USA • 800-546-1232 • www.asicentral.ca

402-814064-0208

Payment Information Name of Cardholder:

Please check proper membership solution:nn Basic Membership $399.00 CDN*Price does not include $165 CDN one-time only non-refundable processing fee or GST.

Check card to be charged:nn American Express nn Discover nn MasterCard nn VISA

Card Number:

Expiration Date:

Cardholder Signature:

nn Please use this credit card information for my credit card

of record for future purchases.

Or, if you would prefer to pay by check, please make payableto ASI and mail to … Attention: ASI Distributor Membership Services

4800 Street Road, Trevose, PA 19053-6698 USA

Sign Up for Your UPS Discounts Here!Once you are an ASI member, you can save up to 25% on UPS shipping justby completing this information.Street Address (No P.O Boxes):

City: Province: Postal code:

Name:

Signature:

UPS® Shipper Number (if applicable):

I hereby request and authorize ASI to open a UPS® account for my company to take advantage of the ASI shippingprogram incentives. I understand the shipping incentives will begin 10 working days after I receive my ASI numberand there are no other incentives available to my existing UPS® account number.

Agreed to:

Applicant Company Name

by Date Signature of Corporate Officer, Partner or Owner

Print Name Print Title

I hereby authorize and consent for the company/organization noted on this document to receive faxes or emails sent by or on behalf of ASI®, The ASI Show!®,and ASI Computer Systems™ to the fax numbers and e-mail addresses provided in this document.

Questions?Please contact Distributor Membership Services Toll free: 1-800-546-1232 • FAX: 1-800-546-1269 • membership@.asicentral.com • Thank you for applying to ASI Canada.

1. I am a corporate officer, partner or owner of the Company named in this Applicationand am authorized to legally bind the Company.

2. I have reviewed this Application and represent that the data and statements containedtherein are true and correct, and are an accurate description of the Company’s policies,resources, products and services marketed as a specialty advertising distributor. I UNDER-STAND AND ACCEPT THAT IF ANY OF THE INFORMATION THAT I HAVE PRO-VIDED CONCERNING THIS APPLICATION IS FALSE, ASI MAY DELIST MYCOMPANY AS AN ASI LISTED DISTRIBUTOR, BILL ME OR MY COMPANY FORTHE COST OF ATTEMPTING TO VERIFY THE FALSE INFORMATION AND/ORTAKE ANY AND ALL APPROPRIATE LEGAL ACTIONS. I FURTHER AGREE,THAT MY COMPANY OR I SHALL BE RESPONSIBLE FOR ALL COSTS (INCLUD-ING LEGAL COSTS) THAT ASI MAY INCUR IN PURSUING SUCH ACTIONS.

3. Your assigned ASI Number and listing in ASI databases, publications and servicesrequires that the Company comply with ASI membership requirements and pay mem-bership dues.

4. ASI may rely on the data. All or part of the data, together with pertinent information con-cerning the Company obtained from ASI Network suppliers and distributors, may be setforth in the ASI Credit Service, in ASI directories, and computer services and provided toother entities. ASI may request written or oral verification of the data and of the Company’stransactions, credit history and qualifications to be listed from the Company and from pres-ent and future subscribers of ASI services and from others. If not verified to its satisfaction,ASI may refuse to list the Company as a distributor and may withdraw the affected datafrom future reports and literature. Upon request, the Company will promptly and accurate-ly complete, sign and return to ASI periodic distributor listing updates, annual surveys orsimilar documents. If ASI determines that the Company is no longer actively and regularlyengaged in the business as stated in this Application, or if the Company fails to providerequested updates or fails to meet listing criteria, ASI, in its sole discretion, may delist theCompany and withdraw its ASI Identification Number.

5. The official ASI Identification Number, (the “ASI Number”) licensed to the Company isproperty of and is a part of the ASI confidential, proprietary and copyrighted distributornumbering system. The ASI Number will be used SOLELY in connection with the con-duct of the Company’s business as a specialty advertising/promotional products distribu-tor and for use SOLELY by the Company, and may not be assigned, transferred or other-wise made available for use by any other entity or individual. The ASI Number is intend-ed for the purpose of identifying your Company to the ASI Distributor and SupplierNetwork and does not imply ASI endorsement of your Company’s products or policies.The Company shall take no action to indicate that it has ownership of the number.

6. The Company further agrees: to maintain the confidentiality of all proprietary, confidentialor copyrighted information received from ASI; not to copy, in whole or in part or prepareany other work from such information; not to transfer such information to any electronic ormechanical addressing or data processing system; to use such information only in connec-tion with its business as a distributor of specialty advertising products; and will not furnishsuch information, in any form, to any other company or individual other than to identify theCompany to a vendor for purposes of purchasing products or obtaining lines of credit.

7. In the event the Company breaches any of the terms and conditions stated herein, ASI,in its sole discretion, may in addition to its other legal remedies: obtain reimbursementof its legal fees incurred in curing such breach; delete the Company’s listing from theASI database reports and literature; withdraw permission to use the number; and/ordiscontinue other ASI services. Upon request, the Company shall immediately return toASI all confidential, proprietary or copyrighted materials, including copies.

8. ASI will use reasonable efforts to avoid errors in reporting the data in this Applicationto authorized suppliers. The entire liability of ASI and the Company’s exclusive reme-dy in the event of ASI error shall be for ASI to promptly attempt to correct those errorsthat are reported by the Company to ASI.

9. Each of those individuals listed in this Application as an officer, partner or owner of theCompany, as well as those individuals who may be added from time to time by theCompany, may be relied upon by ASI as having authority to represent and makechanges on behalf of the Company in connection with the data in this Application,unless and until ASI receives notification in writing from the Company that such indi-vidual does not have such authority.

10. IN NO EVENT SHALL ASI BE LIABLE FOR ANY INCIDENTAL, INDIRECT,punitive, SPECIAL OR CONSEQUENTIAL DAMAGES of any kind, INCLUDINGBUT NOT LIMITED TO LOST REVENUES OR PROFITS, REGARDLESS OF THEFORM OF THE ACTION WHETHER IN CONTRACT, TORT (INCLUDING NEG-LIGENCE), OR OTHERWISE, EVEN IF ASI HAS BEEN ADVISED OF THE POS-SIBILITY OF SUCH DAMAGES. IN NO EVENT SHALL THE MAXIMUM LIA-BILITY OF ASI EXCEED THE APPLICATION AND MEMBERSHIP FEE.

11. Applicant agrees that these terms and conditions and their application shall be governed inaccordance with the laws of the Commonwealth of Pennsylvania without giving effect to anychoice or conflicts of law. By submitting this application, Applicant agrees that any action atlawsuit in equity or other judicial proceeding concerning the application or the terms andconditions shall be decided exclusively by and in a state or federal court in Pennsylvania andaccordingly consents to the exclusive jurisdiction and venue of the Common Pleas Courts ofBucks County, Pennsylvania or the United States Federal District Court for the EasternDistrict of Pennsylvania.

12. The Company shall be obligated and be responsible for the proper performance of theseterms and conditions by its representatives, employees, agents and independent contractors.

13. The initial term of your membership is one (1) year. After the initial term, your mem-bership will automatically renew for successive one (1) year terms at the then-currentrates with no refunds unless either party provides notice of termination to the otherparty thirty (30) days prior to the anniversary date. These terms and conditions shall bebinding upon the Company’s heirs, successors and permitted assigns.

14. ASI may at any time require verification by an Officer of your Company and verifica-tion by an outside CPA auditor (secured at your expense) that the Company meets thelisting qualifications, as well as verification of the accuracy and completeness of thedata, set forth in this Application.

15. ASI products and services that are not part of your membership selection are availableat a separate charge, and are not part of the listing requirements nor processing fee.

16. ASI reserves the right, in its sole discretion, whether to approve or deny any listingapplication.

17. The failure of ASI to partially or fully exercise any right or the waiver by ASI of anybreach shall not prevent a subsequent exercise of such right or be deemed a waiver ofany subsequent breach of the same or any other term or condition.

18. No presumption or burden of proof or persuasion shall be implied by virtue of the factthese Terms & Conditions were prepared by a particular party. These Terms &Conditions set forth the entire agreement between the parties on this subject and super-sedes all prior negotiations, understandings and agreements between the parties concern-ing the subject matter. No amendment or modification of these Terms & Conditions shallbe made except by a writing signed by an officer of the party to be bound thereby.