EXHIBIT 7
SUBSCRIPTION AGREEMENT
Cyberspace Vita, Inc.
Xxxxxxx, Xxxxxxxxxx 00000
00-000 Xx Xxxxx, Xxxxx 000
Xxxx Xxxxxx, Xxxxxxxxxx 00000
Gentlemen:
The undersigned represents as set forth below and subscribes to purchase
________Shares at $.10 per Share, for $_______________, subject to your
acceptance of this subscription. There is no minimum contingency and proceeds
may be used at the issuer's discretion. If any checks are delivered to any
NASD member, the member must promptly, by noon of the next business day,
transmit all checks received to the issuer or any person entitled thereto. The
undersigned, if an individual, is a resident of, or, if a corporation,
partnership or trust, has as its principal place of business:
The state of California_______
The State of New York_____
The State of Florida_____
The District of Columbia _____Other State _____________
A State foreign to U.S.A._____
Dated:______________.
Signature: _________________________
If not an individual
__________________________________________________
Name of Corporation, Trust, Print or type name of or Partnership Signer
__________________________________________________
State where incorporated, P.O. Box or Street Address organized, or domiciled
__________________________________________________
Print Signer's Capacity, City, State and Zip Code
_________________________
Tax ID Number
____________________________
Telefax and Phone Numbers
_________________________
Social Security
