Common use of FORM OF SUBSCRIPTION Clause in Contracts

FORM OF SUBSCRIPTION. TO: Nexaira Wireless Inc. 1404 – 000 Xxxx Xxxxxxxx Xxxxxx Xxxxxxxxx, Xxxxxxx Xxxxxxxx Xxxxxx X0X 0X0 The undersigned Holder of the within Warrants hereby subscribes for ____________ common shares (the “Shares”) of Nexaira Wireless Inc. (the “Company”) pursuant to the within Warrants at US$1.50 per Share on the terms specified in the said Warrants. This subscription is accompanied by a certified cheque or bank draft payable to or to the order of the Company for the whole amount of the purchase price of the Shares. The undersigned represents that, at the time of the exercise of these Warrants, all of the representations and warranties contained in Section 6 of the Subscription Agreement between the Company and the undersigned pursuant to which these Warrants were issued are true and accurate. The undersigned hereby directs that the Shares be registered as follows: TOTAL: (Please print full name in which share certificates are to be issued, stating whether Mr., Mrs. or Miss is applicable). DATED this ________ day of __________________, ______. In the presence of: Signature of Witness Signature of Warrant Holder

Appears in 1 contract

Samples: Subscription Agreement (Nexaira Wireless Inc.)

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FORM OF SUBSCRIPTION. TO: Nexaira Wireless Inc. 1404 – 000 Xxxx Xxxxxxxx Xxxxxx Xxxxxxxxx, Xxxxxxx Xxxxxxxx Xxxxxx X0X 0X0 The undersigned Holder of the within Warrants hereby subscribes for ____________ common shares (the “Shares”) of Nexaira Wireless Inc. (the “Company”) pursuant to the within Warrants at US$1.50 1.00 per Share on the terms specified in the said Warrants. This subscription is accompanied by a certified cheque or bank draft payable to or to the order of the Company for the whole amount of the purchase price of the Shares. The undersigned represents that, at the time of the exercise of these Warrants, all of the representations and warranties contained in Section 6 of the Subscription Agreement between the Company and the undersigned pursuant to which these Warrants were issued are true and accurate. The undersigned hereby directs that the Shares be registered as follows: TOTAL: (Please print full name in which share certificates are to be issued, stating whether Mr., Mrs. or Miss is applicable). DATED this ________ day of __________________, ______. In the presence of: Signature of Witness Warrant Holder Signature of Warrant HolderWitness

Appears in 1 contract

Samples: Private Placement Subscription Agreement (Nexaira Wireless Inc.)

FORM OF SUBSCRIPTION. TO: Nexaira Wireless Inc. 1404 – 000 Xxxx Xxxxxxxx Xxxxxx Xxxxxxxxx, Xxxxxxx Xxxxxxxx Xxxxxx X0X 0X0 The undersigned Holder of the within Warrants hereby subscribes for _____________ common shares (the “Shares”) of Nexaira Wireless Inc. (the “Company”) pursuant to the within Warrants at US$1.50 1.00 per Share on the terms specified in the said Warrants. This subscription is accompanied by a certified cheque or bank draft payable to or to the order of the Company for the whole amount of the purchase price of the Shares. The undersigned represents that, at the time of the exercise of these Warrants, all of the representations and warranties contained in Section 6 of the Subscription Agreement between the Company and the undersigned pursuant to which these Warrants were issued are true and accurate. The undersigned hereby directs that the Shares be registered as follows: TOTAL: (Please print full name in which share certificates are to be issued, stating whether Mr., Mrs. or Miss is applicable). DATED this _________ day of ___________________, ________. In the presence of: Signature of Witness Signature of Warrant Holder

Appears in 1 contract

Samples: Subscription Agreement (Nexaira Wireless Inc.)

FORM OF SUBSCRIPTION. TO: Nexaira Wireless Global Health Ventures Inc. 1404 – 000 0000 Xxxx Xxxxxxxx 00xx Xxxxxx Xxxxxxxxx, Xxxxxxx Xxxxxxxx Xxxxxx X0X 0X0 The undersigned Holder of the within Warrants hereby subscribes for ____________ common shares (the “Shares”) of Nexaira Wireless Global Health Ventures Inc. (the “Company”) pursuant to the within Warrants at US$1.50 _____ per Share on the terms specified in the said Warrants. This subscription is accompanied by a certified cheque or bank draft payable to or to the order of the Company for the whole amount of the purchase price of the Shares. The undersigned represents that, at the time of the exercise of these Warrants, all of the representations and warranties contained in Section 6 of the Subscription Agreement between the Company and the undersigned pursuant to which these Warrants were issued are true and accurate. The undersigned hereby directs that the Shares be registered as follows: TOTAL: (Please print full name in which share certificates are to be issued, stating whether Mr., Mrs. or Miss is applicable). DATED this ________ day of ___________________ , ______. In the presence of: Signature of Witness Signature of Warrant Holder

Appears in 1 contract

Samples: Private Placement Subscription Agreement (Global Health Ventures Inc.)

FORM OF SUBSCRIPTION. TO: Nexaira Wireless Inc. 1404 – 000 PointStar Entertainment Corp. Xxxx Xxxxxx Xxxxxxxx 0 Xxxxx # 000,X.X. Xxx 000000 Xxxxx, Xxxxxx Xxxx Xxxxxxxx Xxxxxx Xxxxxxxxx, Xxxxxxx Xxxxxxxx Xxxxxx X0X 0X0 The undersigned Holder of the within Warrants hereby subscribes for ____________ common shares (the “Shares”) of Nexaira Wireless Inc. Pointstar Entertainment Corp. (the “Company) pursuant to the within Warrants at US$1.50 0.60 per Share on the terms specified in the said Warrants. This subscription is accompanied by a certified cheque or bank draft payable to or to the order of the Company for the whole amount of the purchase price of the Shares. The undersigned represents that, at the time of the exercise of these Warrants, all of the representations and warranties contained in Section 6 of the Subscription Agreement between the Company and Holder hereby certifies that the undersigned pursuant to which these Warrants were issued are true is not a U.S. person and accurateis not subscribing for the Shares on Behalf of a U.S. person. The undersigned hereby directs that the Shares be registered as follows: TOTAL: (Please print full name in which share certificates are to be issued, stating whether Mr., Mrs. or Miss is applicable). DATED this ________ day of ___________________ , ______. In the presence of: Signature of Witness Signature of Warrant Holder

Appears in 1 contract

Samples: Private Placement Subscription Agreement (PointStar Entertainment Corp.)

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FORM OF SUBSCRIPTION. TO: Nexaira Wireless Inc. 1404 – Urex Energy Corp. 00000 X. XxXxxxxx Xxxx. Xxxxxxxx 000-000 Xxxx Xxxxxxxx Xxxx, Xxxxxx Xxxxxxxxx, Xxxxxxx Xxxxxxxx Xxxxxx X0X 0X0 00000 XXX The undersigned Holder of the within Warrants hereby subscribes for ____________ common shares (the "Shares") of Nexaira Wireless Inc. Urex Energy Corp. (the "Company") pursuant to the within Warrants at US$1.50 0.50 per Share on the terms specified in the said Warrants. This subscription is accompanied by a certified cheque or bank draft payable to or to the order of the Company for the whole amount of the purchase price of the Shares. The undersigned represents that, at the time of the exercise of these Warrants, all of the representations and warranties contained in Section 6 of the Subscription Agreement between the Company and the undersigned pursuant to which these Warrants were issued are true and accurate. The undersigned hereby directs that the Shares be registered as follows: TOTAL: (Please print full name in which share certificates are to be issued, stating whether Mr., Mrs. or Miss is applicable). DATED this ________ day of ___________________ , ______. In the presence of: Signature of Witness Signature of Warrant HolderHolder Name (Mr./Mrs./Miss) _________________________________________________________ Address _________________________________________________________

Appears in 1 contract

Samples: Private Placement Subscription Agreement (Urex Energy Corp.)

FORM OF SUBSCRIPTION. TO: Nexaira Wireless Inc. 1404 – 000 PointStar Entertainment Corp. Xxxx Xxxxxx Xxxxxxxx 0 Xxxxx # 000,X.X. Xxx 000000 Xxxxx, Xxxxxx Xxxx Xxxxxxxx Xxxxxx Xxxxxxxxx, Xxxxxxx Xxxxxxxx Xxxxxx X0X 0X0 The undersigned Holder of the within Warrants hereby subscribes for ____________ common shares (the “Shares”) of Nexaira Wireless Inc. Pointstar Entertainment Corp. (the “Company) pursuant to the within Warrants at US$1.50 0.55 per Share on the terms specified in the said Warrants. This subscription is accompanied by a certified cheque or bank draft payable to or to the order of the Company for the whole amount of the purchase price of the Shares. The undersigned represents that, at the time of the exercise of these Warrants, all of the representations and warranties contained in Section 6 of the Subscription Agreement between the Company and Holder hereby certifies that the undersigned pursuant to which these Warrants were issued are true is not a U.S. person and accurateis not subscribing for the Shares on Behalf of a U.S. person. The undersigned hereby directs that the Shares be registered as follows: TOTAL: (Please print full name in which share certificates are to be issued, stating whether Mr., Mrs. or Miss is applicable). DATED this ________ day of ___________________ , ______. In the presence of: Signature of Witness Signature of Warrant Holder

Appears in 1 contract

Samples: Private Placement Subscription Agreement (PointStar Entertainment Corp.)

FORM OF SUBSCRIPTION. TO: Nexaira Wireless Inc. 1404 – Urex Energy Corp. 00000 X. XxXxxxxx Xxxx. Xxxxxxxx 000-000 Xxxx Xxxxxxxx Xxxx, Xxxxxx Xxxxxxxxx, Xxxxxxx Xxxxxxxx Xxxxxx X0X 0X0 00000 XXX The undersigned Holder of the within Warrants hereby subscribes for ____________ common shares (the "Shares") of Nexaira Wireless Inc. Urex Energy Corp. (the "Company") pursuant to the within Warrants at US$1.50 1.00 per Share on the terms specified in the said Warrants. This subscription is accompanied by a certified cheque or bank draft payable to or to the order of the Company for the whole amount of the purchase price of the Shares. The undersigned represents that, at the time of the exercise of these Warrants, all of the representations and warranties contained in Section 6 of the Subscription Agreement between the Company and the undersigned pursuant to which these Warrants were issued are true and accurate. The undersigned hereby directs that the Shares be registered as follows: TOTAL: (Please print full name in which share certificates are to be issued, stating whether Mr., Mrs. or Miss is applicable). DATED this ________ day of ___________________ , ______. In the presence of: __________________________________________ ________________________________________ Signature of Witness Signature of Warrant HolderHolder Name (Mr./Mrs./Miss) __________________________________________________________ Address __________________________________________________________

Appears in 1 contract

Samples: Private Placement Subscription Agreement (Urex Energy Corp.)

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