North America Distributor Application
Applicant Information If enrolling as a business entity, you must also fill out the ...
The term of the Distributor Agreement is one year and may be renewed for successive one year terms on each anniversary dat...
Terms & Conditions
1.	 I understand that as a Syntek Global Distributor:
a.	 I have the right to offer for sale Syntek Glo...
Notice of Right to Cancel
DATE of Transaction: ________________________________________
You may CANCEL this transaction, w...
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Syntek Global North America Distributor Application

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Syntek Global Application
Chantelle McLeod
ID: 13EFD or 27E04
www.FuelPays.com

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Syntek Global North America Distributor Application

  1. 1. North America Distributor Application Applicant Information If enrolling as a business entity, you must also fill out the Business Entity Registration Form. Please Print Legibly SS Number orTax ID (Required) NAME: (First, MI, Last) ______________________________________________________ ADDRESS: _____________________________________________________________ APT/SUITE #: _________ CITY: ________________________________ STATE: ________ZIP: ____________ COUNTRY: ___________ PHONE: (Daytime) _______________________ PHONE: (Cell) _____________________ PHONE: (Home) ________________ FAX: _________________________________ EMAIL: ______________________________________________ DATE OF BIRTH: Required for ProPay account ADDRESS: _____________________________________________________________ APT/SUITE #: ________ CITY: ________________________________ STATE:____________ ZIP: ________ COUNTRY: __________ Shipping Information Check if same as above NAME: (First, MI, Last) ______________________________________________________ ID #: ________________ PHONE: _____________________ PLACEMENT NAME/ID#: ________________ Left Leg Right Leg Your Sponsor’s Information 250 PV Kit ($310) - Includes: Enrollment Fee, (1) 4 oz Bottle of XFT, (1) 2 oz Bottle of XFT, (1) 1 oz Bottle of XFT, (10) 10 mL Foil Packs of XFT, (3) 5 mL Foil Packs of XFT, (1) 12 oz Bottle of Eco-Mist, 1 Syntek Back Pack, 1 Product Holder, 1 Ascend Magazine, 1 Typical Results Pattern Sheet, 5 Gas Cap Stickers, 7 Tracking/Product Brochures, 5 Opportunity Brochures, 4 Folders, 1 Instruction Letter,1 New Distributor Pin and Welcome letter, 1 Flip Chart, 5 DVDs, 5 One-Page Opportunity Sheets, 5 One-Page Training Sheets, Website set-up and 1st Month subscripton to MySyntek. 500PVKit($615)-Includes:EnrollmentFee,(1)4ozBottleofXFT,(1)2ozBottleofXFT,(1)1ozBottleofXFT,(50)10mLFoilPacksofXFT, (5) 5 mL Foil Packs of XFT, (1) 12 oz Bottle of Eco-Mist, 1 Syntek Back Pack, 1 Product Holder, 1 Ascend Magazine, 1 Typical Results Pattern Sheet, 5 Gas Cap Stickers, 9 Tracking/Product Brochures, 7 Opportunity Brochures, 1 Pen, 1 Note Pad, 1 New Distributor Pin and Welcomeletter,6Folders,1InstructionLetter,1FlipChart,15 DVDs,15One-PageOpportunitySheets,15One-PageTrainingSheets,Website set-up and 1st Month subscripton to MySyntek. Fast Start Kits Check One Monthly Autoship The Autoship is billed and shipped 30 days after a Fast Start Kit is purchased. 12382 South Gateway Park Place Suite B800 Draper, UT 84020 P: 801-386-5007 F: 801-386-5004 Toll Free 1-877-SYNTEK1 www.SyntekGlobal.com North America - Effective June 26, 2013 1 __ __ / __ __ / __ __ MM / DD / YY Check One 50 PV AutoShip ($63) (Binary Commissions & Retail Bonus) (17) 10 mL Foil Packs of XFT (1) 2 oz Bottle and (10) 10 mL Foil Packs of XFT (3) 2 oz Bottles of XFT (5) 1 oz Bottles of XFT (1) 4 oz Bottle and (1) 2 oz Bottle of XFT (1) 4 oz Bottle of XFT and (1) 12 oz Bottle of Eco-Mist 100 PV AutoShip ($125) (Required for full Compensation Plan Commissions & Bonuses) (34) 10 mL Foil Packs of XFT (2) 2 oz Bottles and (20) 10 mL Foil Packs of XFT (52) 5 mL Foil Packs of XFT (10) 1 oz Bottles of XFT (2) 4 oz and (2) 2 oz Bottles of XFT (22) 10 mL Foil Packs of XFT and (2) 12 oz Bottles of Eco-Mist *Price does not include tax and shipping. C1Rose Inc. - www.FuelPays.com www.C1Rose.MySyntek.com - 647-786-7222 C1Rose Consulting 27 E 04 647-786-7222
  2. 2. The term of the Distributor Agreement is one year and may be renewed for successive one year terms on each anniversary date of the Agreement. If the Agreement is not renewed on each anniversary date, it will be cancelled and you will lose all rights as a Syntek Global Distributor. So that you do not inadvertently forget to renew and lose these benefits, Syntek Global offers an optional automatic renewal program. Your Distributor Agreement will automatically be renewed on each anniversary date and the renewal fee of $29.95 will be charged to your credit card. YES, automatically renew my Distributor Agreement on each anniversary date of my enrollment and charge my renewal fee to my credit card. NO, I do not wish to participate in the automatic renewal program. I understand that it is my responsibility to renew my Agreement on or before each anniversary date. Automatic Annual Renewal (Optional) You, the buyer, may cancel this transaction at any time prior to midnight of the third business day after the date of this transaction (five days for Alaska residents). Refer to the Terms and Conditions of this form for a complete explanation. I have carefully read theTerms and Conditions of this Application, the Syntek Global Policies and Procedures, and the Syntek Global Marketing and Compensation Plan, and agree to abide by all terms set forth in these documents. I understand that I have the right to terminate my Syntek Global independent distributorship at any time, with or without reason, by sending written notice to the Company at the above listed address. APPLICANT’S SIGNATURE: ______________________________________________ DATE: _______________ CO-APPLICANT’S SIGNATURE: ___________________________________________ DATE: _______________ Mail the completed signed original Application to: Syntek Global, Distributor Application Dept., 12382 S. Gateway Park Place, Suite B800, Draper, Utah 84020 or Fax to (801) 386-5004. If Application is faxed, you must fax both pages 1 and 2 of the Application. (1) By entering my Social Security Number (or Federal Tax Identification Number, if applicable) on this Distributor Application, I certify that this number is my correct taxpayer identification number. (2) I have not been a Syntek Global Distributor, or a partner, shareholder, or principal of any entity having a Syntek Global business within the past six months. (3) I understand that any intentional misrepresentation of any information I provide on this Distributor Application and Agreement may result in action by Syntek Global, up to and including termination of this Agreement. Note: If you selected Autoship for your product, this card will be used for each monthly transaction. NAME: (on credit card) ____________________________ CARD TYPE: Visa Master Card Amex CREDIT CARD #: ___________________________ Verification Code: _____________ EXP. DATE: __________ ADDRESS: _____________________________________________________________ APT/SUITE #: ________ CITY: ________________________________ STATE:____________ ZIP: ________ COUNTRY: ______________ By signing, I authorize Syntek Global to charge my credit card for all orders and payments indicated on this Application and Agreement. SIGNATURE: ___________________ DATE: _______________ INITIAL PAYMENT: *Cash *Check Credit Card (*Only available at Will Call.) Payment Information Same as Applicant Same as Shipping Discover 12382 South Gateway Park Place Suite B800 Draper, UT 84020 P: 801-386-5007 F: 801-386-5004 Toll Free 1-877-SYNTEK1 www.SyntekGlobal.com North America - Effective June 26, 2013 2 Website Setup Signature Go to www.MySyntek.com to reserve your replicated website! Preferred URL Website Name: _____________________________________________________________________________ If you choose to get a website at the time of enrollment (now), your first month will be FREE! Please Choose: Website membership--$14.95 Premium membership (Multiple Websites & 18 PV)--$24.95 No Website
  3. 3. Terms & Conditions 1. I understand that as a Syntek Global Distributor: a. I have the right to offer for sale Syntek Global products and services in accordance with these Terms and Conditions. b. I have the right to enroll persons in Syntek Global. c. If qualified, I have the right to earn commissions pursuant to the Syntek Global Marketing and Compensation Plan. 2. I agree to present the Syntek Global Marketing and Compensation Plan and Syntek Global products and services as set forth in official Syntek Global literature. 3. I agree that as a Syntek Global Distributor I am an independent contractor, and not an employee, partner, legal representative, or franchisee of Syntek Global. I agree that I will be solely responsible for paying all expenses incurred by myself, including but not limited to, travel, food, lodging, secretarial, office, long distance telephone and other expenses. I UNDERSTAND THAT I SHALL NOT BE TREATED AS AN EMPLOYEE OF SYNTEK GLOBAL FOR FEDERAL OR STATE TAX PURPOSES. Syntek Global is not responsible for withholding, and shall not withhold or deduct from my bonuses and commissions, if any, FICA, or taxes of any kind. 4. I have carefully read and agree to comply with the Syntek Global Policies and Procedures and the Syntek Global Marketing and Compensation Plan, both of which are incorporated into and made a part of these Terms and Conditions (these three documents shall be collectively referred to as the “Agreement”). I understand that I must be in good standing, and not in violation of the Agreement, to be eligible for bonuses or commissions from Syntek Global. I understand that these Terms and Conditions, the Syntek Global Policies and Procedures, or the Syntek Global Marketing and Compensation Plan may be amended at the sole discretion of Syntek Global, and I agree to abide by all such amendments. Notification of amendments shall be posted on the Syntek Global website. Amendments shall become effective 30 days after publication. The continuation of my Syntek Global business or my acceptance of bonuses or commissions shall constitute my acceptance of any and all amendments. 5. The term of this Agreement is one year (subject to prior cancellation as provided in the Policies and Procedures). If I fail to annually renew my Syntek Global business, or if it is canceled or terminated for any reason, I understand that I will permanently lose all rights as a Distributor. I shall not be eligible to sell Syntek Global products and services nor shall I be eligible to receive commissions, bonuses, or other income resulting from the activities of my former downline sales organization. In the event of cancellation, termination or non renewal, I waive all rights I have, including but not limited to property rights, to my former downline organization and to any bonuses, commissions or other remuneration derived through the sales and other activities of my former downline organization. Syntek Global reserves the right to terminate all Distributor Agreements upon 30 days notice if the Company elects to: (1) cease business operations; (2) dissolve as a business entity; or (3) terminate distribution of its products and/or services via direct selling channels. Distributor may cancel this Agreement at any time, and for any reason, upon written notice to Syntek Global at its principal business address. Syntek Global may cancel this Agreement for any reason upon 30 days advance written notice to Distributor. 6. I may not assign any rights or delegate my duties under the Agreement without the prior written consent of Syntek Global. Any attempt to transfer or assign the Agreement without the express written consent of Syntek Global renders the Agreement voidable at the option of Syntek Global and may result in termination of my business. 7. I understand that if I fail to comply with the terms of the Agreement, Syntek Global may, at its discretion, impose upon me disciplinary action as set forth in the Policies and Procedures. If I am in breach, default or violation of the Agreement at termination, I shall not be entitled to receive any further bonuses or commissions, whether or not the sales for such bonuses or commissions have been completed. 8. Syntek Global, its parent or affiliated companies, directors, officers, shareholders, employees, assigns, and agents (collectively referred to as “affiliates”), shall not be liable for, and I release Syntek Global and its affiliates from, all claims for consequential and exemplary damages for any claim or cause of action relating to the Agreement. I further agree to release Syntek Global and its affiliates from all liability arising from or relating to: (a) any Distributor’s breach of this Agreement or the Policies and Procedures; (b) the promotion or operation of a Syntek Global business by a Distributor and any activities related to it, including but not limited to, the presentation of Syntek Global products or the Syntek Global Marketing and Compensation Plan, the operation of a motor vehicle, the lease of meeting or training facilities, etc.), and agree to indemnify Syntek Global for any liability, damages, fines, penalties, or other; (c) any incorrect data or information provided by a Distributor to Syntek Global; (d) a Distributor’s failure to provide any information or data necessary for Syntek Global to operate its business; or (e) awards arising from any unauthorized conduct that I undertake in operating my business. 9. The Agreement, in its current form and as amended by Syntek Global at its discretion, constitutes the entire contract between Syntek Global and myself. Any promises, representations, offers, or other communications not expressly set forth in the Agreement are of no force or effect. 10. Any waiver by Syntek Global of any breach of the Agreement must be in writing and signed by an authorized officer of Syntek Global. Waiver by Syntek Global of any breach of the Agreement by me shall not operate or be construed as a waiver of any subsequent breach. 11. If any provision of the Agreement is held to be invalid or unenforceable, such provision shall be reformed only to the extent necessary to make it enforceable, and the balance of the Agreement will remain in full force and effect. 12. This Agreement will be governed by and construed in accordance with the laws of the State of Utah without regard to principles of conflicts of laws. All disputes and claims relating to Syntek Global, the Distributor Agreement, the Syntek Global Marketing and Compensation Plan or its products and services, the rights and obligations of an independent Distributor and Syntek Global, or any other claims or causes of action relating to the performance of either an independent Distributor or Syntek Global under the Agreement or the Syntek Global Policies and Procedures shall be settled totally and finally by arbitration in Salt Lake City, Utah, or such other location as Syntek Global prescribes, in accordance with the Federal Arbitration Act and the Commercial Arbitration Rules of the American Arbitration Association, except that all parties shall be entitled to discovery rights allowed under the Federal Rules of Civil Procedure. All issues related to arbitration shall be governed by the Federal Arbitration Act. The decision of the arbitrator shall be final and binding on the parties and may, if necessary, be reduced to a judgment in any court of competent jurisdiction. Each party to the arbitration shall be responsible for its own costs and expenses of arbitration, including legal and filing fees.This agreement to arbitrate shall survive any termination or expiration of the Agreement. Nothing in the Agreement shall prevent Syntek Global from applying to and obtaining from any court having jurisdiction a writ of attachment, garnishment, temporary injunction, preliminary injunction, permanent injunction or other equitable relief available to safeguard and protect its interest prior to, during or following the filing of any arbitration or other proceeding or pending the rendition of a decision or award in connection with any arbitration or other proceeding. 13. The parties consent to jurisdiction and venue before any federal or state court in Salt Lake County, State of Utah, for purposes of enforcing an award by an arbitrator or any other matter not subject to arbitration. 14. Louisiana Residents: Notwithstanding the foregoing, Louisiana residents may bring an action against the Company with jurisdiction and venue as provided by Louisiana law. 15. Montana Residents: A Montana resident may cancel his or her Distributor Agreement within 15 days from the date of enrollment, and may return his or her starter kit for a full refund within such time period. 16. If a Distributor wishes to bring an action against Syntek Global for any act or omission relating to or arising from the Agreement, such action must be brought within one year from the date of the alleged conduct giving rise to the cause of action. Failure to bring such action within such time shall bar all claims against Syntek Global for such act or omission. Distributor waives all claims that any other statutes of limitations apply. 17. I authorize Syntek Global to use my name, photograph, personal story and/or likeness in advertising or promotional materials and waive all claims for remuneration for such use. 18. A faxed copy of the Agreement shall be treated as an original in all respects. 19. Autoship Terms and Conditions. If you selected either Autoship option, the following terms and conditions apply: a. I authorize Syntek Global to withdraw payment for my Autoship orders from my credit card or bank account identified in this Agreement. If I have elected to pay by checking account debit, I hereby authorize Syntek Global to electronically withdraw payment from my checking account for my Autoship orders as authorized herein. Syntek Global is authorized to withdraw payment equal only to the amount of the products, applicable sales tax, and shipping and handling for the Autoship orders I have selected. I agree to pay a $20.00 service fee in the event a check or charge is returned for any reason. I have the right to have the amount of any erroneous withdrawal deposited into my account as soon as reasonably possible and upon proper notification to Syntek Global. I shall hold Syntek Global harmless for all special or consequential damages, whether direct or indirect, resulting from any wrongful debit to my account. b. To change your Autoship order selections, method of payment, or the authorized amount, a new Autoship Order Form must be submitted to Syntek Global. If more than one Autoship Order Form has been submitted, the most recent will supersede all previous Autoship Order Forms. Syntek Global reserves the right to change its prices associated with its products without notice. c. Your Autoship participation and payment authorization will remain in effect until you: (1) elect to alter or change any aspect thereof by submitting a new signed Autoship Order Form; (2) send, in writing, your cancellation to Syntek Global at the email address, mailing address or fax number listed on this Application and Agreement (Notice must include your name, address, and Distributor ID Number), or (3) stop payment of any withdrawals by Syntek Global by notifying your issuing bank at least three days prior to the scheduled charging of your account. If received fewer than three days prior to the scheduled charging of your account, cancellation will become effective in month following the month in which your notice of cancellation is received by Syntek Global. 12382 South Gateway Park Place Suite B800 Draper, UT 84020 P: 801-386-5007 F: 801-386-5004 Toll Free 1-877-SYNTEK1 www.SyntekGlobal.com North America - Effective June 26, 2013 3
  4. 4. Notice of Right to Cancel DATE of Transaction: ________________________________________ You may CANCEL this transaction, without any penalty or obligation, within THREE BUSINESS DAYS from the above date (5 business days for Alaska residents). If you cancel, any property traded in, any payments made by you under the contract or sale, and any negotiable instrument executed by you will be returned within TEN BUSINESS DAYS following receipt by the seller of your cancellation notice, and any security interest arising out of the transaction will be canceled. If you cancel, you must make available to the seller at your residence, in substantially as good condition as when received, any goods delivered to you under this contract or sale, or you may, if you wish, comply with the instructions of the seller regarding the return shipment of the goods at the seller’s expense and risk. If you do make the goods available to the seller and the seller does not pick them up within 20 days of the date of your Notice of Cancellation, you may retain or dispose of the goods without any further obligation. If you fail to make the goods available to the seller, or if you agree to return the goods to the seller and fail to do so, then you remain liable for performance of all obligations under the contract. To cancel this transaction, mail or deliver a signed and dated copy of this Cancellation Notice or any other written notice, or send a telegram to: Syntek Global Inc. 12382 S. Gateway Park Place Suite B800 Draper, UT 84020 NOT LATER THAN MIDNIGHT of the third business day following the date set forth above. I HEREBY CANCEL THIS TRANSACTION. Buyer’s Signature: ___________________________________________ Date: _____________________________ 12382 South Gateway Park Place Suite B800 Draper, UT 84020 P: 801-386-5007 F: 801-386-5004 Toll Free 1-877-SYNTEK1 www.SyntekGlobal.com North America - Effective June 26, 2013 4

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