Drops Ship Application Form


  1. If you are interested in our Drop ship sales program please provide as much of the following contact information as possible. Because we are releasing  confidential  pricing information to you we need to qualify each new account:

    Name
    Title
    Organization
    Street Address
    Address (cont.)
    City
    State/Province
    Zip/Postal Code
    Country
    Work Phone
    FAX
    E-mail
    URL
    Tax ID # No Sales Tax State
       

For copyright and Trade Mark purposes the following information must be completed by an authorized person representing your company. Please put your name in each box.

John Adair creates original copyrighted jewelry designs and sells pieces incorporating such designs and derivative designs under the mark “HeartPrint”™ in the United States and internationally. John Adair continues to develop new original copyrighted jewelry designs and new marks. We are the only designers and manufacturers of the HeartPrint™ line.

desires to publicly display and market copies of John Adair’s original copyrighted jewelry designs and derivative designs products under John Adair mark in the United States.

acknowledges John Adair exclusive right, title and interest in and to the “HeartPrint”™ mark and John Adair’s the original copyrighted jewelry designs and derivative designs.

will not at any time do or cause to be done any act contesting or in any way impairing or tending to impair any part of such right title and interest.

shall not in any manner represent that it has any ownership in the John Adair mark or original copyrighted jewelry designs and derivative designs.

will not knowingly harm, misuse or bring into disrepute John Adair or the “HeartPrint”™ mark.

This agreement shall be construed, interpreted and applied in accordance with the laws of the United States and the state of Hawaii.

 

If you have any question please contact us at john@alohajewelers.com or call 808-981-5795 M-F 10am-5pm Hawaii time. Our fax is 808-959-6524.

 

I/we understand and agree to all the provisions in this document.

 

Before you submit the form, please print a copy for your records.

 


Author John Adair
Copyright © 2003 [J. Adair Jewelry Design]. All rights reserved.
Revised: 06/17/06