| Daily Newspaper and Las Vegas-based Gaming Companies Subscription Application |
| Subscriber Information BILLING WILL DE DONE MONTHLY |
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| Your name: | |||
| Company name: | |||
| Job Title: | |||
| Your E-mail: | |||
| Telephone: | |||
| Mailing Address: | |||
| City: | |||
| State: | |||
| Zip: | |||
| Country: | |||
| Information on person who should receive the Gaming Wire (only if different from above) | |||
| Full name: | |||
| Job Title: | |||
| Recipient's E-Mail Address(es) | |
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How would you like to receive the Gaming Wire? |
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FIRM NAME |
DBA |
DATE |
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ADDRESS/ CITY/ STATE/ ZIP CODE |
TELEPHONE ( ) |
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BILLING ADDRESS (IF DIFFERENT FROM ABOVE) |
PARENT COMPANY (IF SUBSIDIARY) |
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I certify that the above statements (which are furnished for the purpose of obtaining credit) are true and correct; and I agree to pay court costs and/or reasonable attorney’s fees, or both, if collection is necessary through process of suit. Past due amounts, at Gaming Wire’s option, shall accrue interest at the rate of twelve percent (12%) per annum. It is understood that all accounts are billed on the first of the month and are due by the 15th of the month following insertion.
This contract is entered in and shall be governed by and construed in accordance with the laws of the State of Nevada. The state and federal courts located in Clark County, Nevada, shall have exclusive jurisdiction to hear and determine any claims or disputes between the Gaming Wire and subscriber(s) pertaining to this contract. Subscriber(s) waive any right they may have to assert the doctrine of forum non conveniens (i.e. an inconvenient forum) or otherwise object to such venue. Subscriber(s) expressly submit and consent in advance to such jurisdiction in any action or proceeding commenced in such courts.
APPLICATION MUST BE SIGNED BY AN OWNER, PARTNER, OR OFFICER OF THE FIRM.
PRINT NAME :___________________________________________
TITLE :___________________________________________
SIGNATURE :___________________________________________ DATE :__________________
FOR Gaming Wire USE ONLY / DISPOSTION OF CREDIT APPLICATION
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ACCOUNT NUMBER |
ACCOUNT NAME |
ACCOUNT REPRESENTATIVE |
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___APPROVED - CREDIT LIMIT OF $ _________________PER MONTH ____Not Approved |
REMARKS * ENTER ADDRESS FOR DUPLICATE STATEMENT |
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CREDIT MANAGER |
BUSINESS MANAGER |
DATE |
GENERAL MANAGER |
DATE |
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