PETCARE TV SUBSCRIPTION FORM
This is an agreement between _____________________________ (hereinafter referred
to as "office") and PetCARE Television Network (hereinafter referred to as
"PCTV"). Office hereby agrees to subscribe to the PetCARE Television Network
waiting room video education system (hereinafter referred to as "the system"),
which is a series of regularly-updated client educational video magazines, a
color television monitor, and a DVD player to be placed in the office's
reception area.
Three-year subscription fee: $299 _____ Bill me _____ Xxxx my credit card
Credit Card Type: ___________________________________________________________
Name on Card: _______________________________________________________________
Number: ________________________________________ Expiration: _______
The office will take reasonable precautions to protect the components of the
system requested below from vandalism, tampering, theft, fire, and other
hazards; however, the office will not be liable to PCTV for damaged or stolen
equipment. The office agrees to allow reasonable access to PCTV research
auditors. Participation in the system shall be for a term of three years,
commencing upon first delivery. PCTV has the right to remove the system upon
termination of the agreement. The system and all its components remain the
property of PCTV or its equipment supplier.
Office hereby agrees to:
o Prominently display the system in its reception area
o Play PCTV programming during all client office hours
o Contact PCTV immediately with any system problems
0000 Xxxxx Xxxxxx, #000
Xxxxxxxx Xxxxxxx, XX
00000
Please check one option for your hospital
[ ] Three year subscription PetCARE Television Network's for $297 and
Option 1 receive the PCTV Loaner System which includes you choice of a 13" or
20" Television and accompanying DVD player. The Color TV and DVD
player is yours to use for as long as you are a subscriber. Also,
includes all technical support, service and replacement as needed in
addition to the Quarterly DVD Programs.
[ ] Subscription to PetCARE Television Network's Quarterly DVD
Option 2 Program...$99/year
[ X ] A subscriber benefit is that you are automatically licensed to
Free download individual programs and updates from the PCTV website for use
in your hospital practice as loaner CD's, or exam room use, or just to
give to local schools as part of your practice's public relations
program.
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Veterinarian or Authorized Representative Signature Date
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Veterinarian's Name
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Practice Name Number of Doctors with Practice
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Street Address
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City State Zip
( )
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Telephone Number
( )
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Fax Number
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Email
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Contact's Name (Other than Veterinarian)
Office Hours
Monday __________ to __________ Friday __________ to __________
Tuesday __________ to __________ Saturday __________ to __________
Wednesday __________ to __________ Sunday __________ to __________
Thursday __________ to __________
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Please mail to address below with payment.
For additional information, contact us at:
PetCARE Television Network, Inc.
0000 Xxxxx Xxx.,
Xxxxx 000
Xxxxxxxx Xxxxxxx,
XX, 00000
Tel: 000-000-0000
Tel: 000-000-0000
Fax: 000-000-0000
Efax: 000-000-0000
email:xxxx@xxxxxxxxx.xxx
