Exhibit 1.03
SUBSCRIPTION AGREEMENT
HEALTHLINK INTERNATIONAL, INC.
000 Xxxxxxxx Xxxxx, Xxxxx 000
Xxxxxxxxx, XX 00000
IN ORDER TO PURCHASE Units of HealthLink International, Inc. (the
"Company") as described in the Prospectus dated ______________, accompanying
this Subscription Agreement, each subscriber must complete, execute and return
this Subscription Agreement, along with the payment by check, payable to "Bank
One as HealthLink Escrow Agent" for the Units purchased, to the Company at 000
Xxxxxxxx Xxxxx, Xxxxx 000, Xxxxxxxxx, XX 00000. Capitalized terms used herein
and not otherwise defined shall have the meaning ascribed thereto in the
Prospectus.
1. Subscription
The undersigned (the "Subscriber") hereby subscribes for and agrees to
purchase from the Company subject to the terms and conditions set forth in the
Prospectus dated ______________________ (the "Prospectus"), a copy of which
accompanied this Subscription Agreement, ____ Units of the Company's securities
at a price per Unit of $3.00 or $___________ in the aggregate (the "Subscription
Price").
2. Review
The Subscriber represents that Subscriber has carefully reviewed the
Company's Prospectus.
3. Payment
The Subscription Price must accompany this Subscription and shall be paid
by check payable to "Bank One as HealthLink Escrow Agent."
4. Subscription Information
If an individual:
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Full Name (type or print) Social Security Number
--------------------------------
Address
---------------------------------
City State Zip
---------------------------------
Telephone
HealthLink Subscription Agreement Page 1
If a Corporation:
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Full Corporation Name (type or print) Tax ID Number
---------------------------------
Head Office Address
---------------------------------
City State Zip
---------------------------------
Telephone Number
5. Miscellaneous
(a) All pronouns and any variations thereof used herein shall be deemed to
refer to the masculine, feminine, impersonal, singular or plural, as the
identity of the person or persons may require.
(b) This Subscription Agreement constitutes the legal, valid and binding
obligation of the undersigned enforceable in accordance with its terms. This
Subscription Agreement shall be enforced, governed and construed in all respects
in accordance with the laws of the State of Nevada.
(c) This Subscription Agreement constitutes the entire agreement between
the parties hereto with respect to the subject matter hereof and may be amended
only by writing executed by both parties hereto.
(d) Except as set forth herein, neither this Subscription Agreement nor any
provision hereof shall be waived, modified, changed, discharged, terminated,
revoked or canceled except by an instrument in writing signed by the party
effecting the same against whom any change, discharge or termination is sought.
(e) The Offering may be withdrawn at any time prior to the issuance of
Units to prospective Subscribers. Further, in connection with the offer and sale
of the Units, the Company reserves the right, in its sole discretion, to reject
any subscription in whole or in part or to allot to any prospective subscriber
fewer than the Units applied for by such subscriber. The Units are offered by
the Company subject to prior sale, acceptance or an offer to purchase,
withdrawal, cancellation or modification of the offer, without notice.
(f) This Subscription Agreement does not constitute an offer to sell or a
solicitation of any offer to buy any securities offered hereby by anyone in any
jurisdiction in which such offer or solicitation is not qualified to do so or to
anyone to whom it is unlawful to make such offer or solicitation.
HealthLink Subscription Agreement Page 2
IN WITNESS WHEREOF, TH SUBSCRIBER HAS EXECUTED THIS SUBSCRIPTION
AGREEMENT ON THIS ____ DAY OF ___________, 2000.
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Accepted this ___ day of __________, 2000 Name of Subscriber (Please Type of Print)
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By:_______________________________ (Signature of Subscriber or of duly authorized
(Signature of duly authorized signatory) signatory of a corporation, partnership or
other subscriber that is not a natural person)
Name:________________________________________
Title: ______________________________________
Please print or type name and title of duly
authorized signatory of a corporate,
partnership that is not a natural person
HealthLink Subscription Agreement Page 3
