1) Fill out the form completely,    2)Print it,    3)Sign it    4)Scan and email to eppolito@repromotions.com
Marketing Agreement Between RE Promotions and the following Agent:

Name:        Office Name:
Office Address:
City:    St:    Zip code:

Main Ph: Office Ph: x-  Cell:
Fax: Other:
Email:  

If you have a website with RE Promotions please list it below
Website Name: www.

Credit Card Authorization
I authorize RE Promotions to use the credit card number on file:
Yes             No, please use the card listed below.
Credit Card Number   -     -     -    
Expiration Month and Year     Year
Name of Card Holder:
Address where your credit card bill is delivered:
Credit Card Company: Master Card      Visa

I Authorize RE Promotions to charge my credit card for any and all farming/marketing services that are provided to me by
RE Promotions.  I understand that I will ONLY be charged when I order farming services from RE Promotions.  There is NO agreement in place that states that I must market on a regular schedule.  I will market on an "as needed" basis.
This form pertains to any type of direct-mail marketing (postcards, letters, newsletters).


__________________________________________                    __________________
Agent's Signature                                                                                        Date