EXHIBIT 1.1
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SUBSCRIPTION AGREEMENT
Net-Based Media, Inc.
0000 Xxxxxxxx Xxxxxx
Xxxxx #000, 0xx xxxxx
Xxxxxxxxxxxx, XX 00000
Dear Sirs:
Concurrent with execution of this Subscription Agreement, the
undersigned (the "Purchaser") is purchasing ________________ shares
of Common Stock of Net-Based Media, Inc. (the "Company"), at a price
of $0.05 per Share (the "Subscription Price"), and has received,
read and understands the matters set forth in the Company's
prospectus dated _____________, 2001.
Purchaser hereby confirms the subscription for and purchase of said
number of Shares and hereby agrees to pay herewith the Subscription
Price for such Shares.
MAKE CHECK PAYABLE TO: NET-BASED MEDIA, INC.
Executed this _____ day of ________________, _______, at
_____________________ (Street Address), ___________________ (City),
_________________ (State) ________ (Zip Code).
___________________________________
Signature of Purchaser
___________________________________
Printed Name of Purchaser
___________________________________
Social Security Number/Tax I.D.
Number of Shares Purchased Total Subscription Price
__________________________ ________________________
Form of Payment: Cash _________________
Check# _________________
Other _________________
ACCEPTED THIS _____ DAY OF ________________, _______.
NET-BASED MEDIA, INC.
BY: __________________________________
Title: ___________________________
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