AAES Mailing List Rental Agreement

Document Sample
AAES Mailing List Rental Agreement Powered By Docstoc
					                               AAES Mailing List Rental Agreement



Size and Description: The entire mailing list consists of 333 members in the U.S., Canada and abroad. The
majority of these members reside in the United States. You may request rental of U.S. only, international only, or
the entire list.

Rental Agreement: The AAES Mailing List is available for rent for one time use only. Renters will be billed for
any subsequent unauthorized use, and if continued, legal action will be taken.

Available Formats: The AAES Mailing List can be sent directly to the purchasing company or a designated
mailing house in electronic (Excel) format. Email addresses, phone and fax numbers are not included in the list.

Cost: The list can be purchased at a cost of $1.00 per name. The AAES staff will provide an actual count on a per-
order basis in order to determine the exact amount due.

Approval: AAES requires approval of the mailing prior to the list being emailed. Please send a sample of the
mailing piece with the signed statement and order form.

Delivery Time: It takes approximately 10-14 days for request approval and payment processing. Please be sure to
include a copy of the mailing with the order form or your request will not be processed.

Anyone wishing to rent the AAES mailing list must sign the following statement and return with
the order form to AAES, along with a sample of the mailing piece. AAES must approve your
mailing piece before your request is processed. You may fax the signed statement, order form
and mailing piece to Dr. Sally Carty’s attention at (412) 648-9551.


I,                                               , representing                                         , request
permission to rent the AAES mailing list. I understand that if my request is approved, I may use the mailing list to
send only one mailing of the material that has been approved. I understand that making copies of the list or
entering the list into my own computer is a violation of the rental agreement and the AAES copyright. I also agree
not to replicate the list in any way or use it to create my own list. If I should use the list again without
authorization, I understand that I will be liable for an additional rental fee plus subject to legal action.


Contact’s Signature:                                                         Date:


Please see order form on next page




                                                               iMac_HD:Users:cw:Desktop:Mailing List Agreement Order Form.doc
                                           AAES Mailing List Rental Order Form

Contact Information                                               List should be sent to (if different from contact)

Name:                                                             Name:

Company:                                                          Company:

Address:                                                          Address:

Address:                                                          Address:

City:                                                             City:

State/Province:                                                   State/Province:                                     ______

Zip Code:                                                         Zip Code:

Country:                                                          Country:

Telephone:                                                        Telephone:

Fax:                                                              Fax:

E-Mail:                                                           E-Mail:

Please check the choices below that apply to your order:

Content:
  Entire List
  Partial List – Please Specify:          US only          International Only

Payment Options: By Check or Credit Card.
Please remit checks to: AAES
c/o Dr. Sally Carty, AAES Secretary-Treasurer
University of Pittsburgh School of Medicine
497 Scaife Hall, Department of Surgery
3550 Terrace Street
Pittsburgh, PA 15261

AAES accepts Visa, MasterCard and American Express.

           Visa         MC                AMEX       Name on card:

Card Number:                                                                                Expiration Date:

Cardholder Signature:                                                                                         ________

Total: $                           (Contact AAES for exact count if purchasing a partial list)

                                                            AAES
                                       c/o Dr. Sally Carty, AAES Secretary-Treasurer
                    University of Pittsburgh School of Medicine, 497 Scaife Hall, Department of Surgery
                                          3550 Terrace Street, Pittsburgh, PA 15261
                                        Phone: (412) 647-0467 Fax: (412) 648-9551

                                                                     iMac_HD:Users:cw:Desktop:Mailing List Agreement Order Form.doc
iMac_HD:Users:cw:Desktop:Mailing List Agreement Order Form.doc