MISSING CHILDREN AWARENESS FOUNDATION, INC.

13094   95TH STREET NORTH

LARGO, FL 33773

727-585-5360  (OR)  800-741-SAFE (7233)

FOUNDED 1984

VENDOR APPLICATION

ALL VENDORS ARE REQUIRED TO SEND THEIR FIRST AND LAST MONTH'S PAYMENT TO RECEIVE LABELS.  ALL LABELS ARE SENT OUT WITH A VENDOR NUMBER ON THEM.  DO NOT REMOVE THIS NUMBER AS IT IDENTIFIES YOU AS AN AUTHORIZED VENDOR.  ALL LABELS ARE SUPPLIED BY THE FOUNDATION.  VENDORS ARE NOT AUTHORIZED TO DUPLICATE, COPY OR REPRODUCE LABELS.  VENDORS ARE NOT AUTHORIZED TO USE THE FOUNDATION'S NON-PROFIT STATUS.  BY PLACING THE MCAF LABELS ON YOUR VENDING UNITS, YOU AGREE TO MAKE MONTHLY PAYMENTS IN THE AMOUNT SPECIFIED BY THIS APPLICATION.  IF YOU DECIDE TO DISCONTINUE USING THE FOUNDATION'S LABELS, YOU AGREE TO GIVE THE FOUNDATION A 30-DAY WRITTEN NOTICE.  YOU AGREE TO RETURN ALL LABELS TO THE FOUNDATION AND SEND ANY PAST DUE PAYMENTS IN ORDER TO CLOSE YOUR FILE.  YOUR LAST MONTH'S PAYMENT WILL BE APPLIED WHEN THE LABELS ARE RECEIVED AND YOUR FILE IS CLOSED.

IF YOU HAVE ANY QUESTIONS WHILE FILLING OUT THIS APPLICATION, CONTACT US AT THE ABOVE PHONE NUMBERS.

PLEASE PRINT THIS PAGE, SIGN AND MAIL.  You must mail a money order or check *(see below) before you receive your labels.

NUMBER OF UNITS-_____ x $1.50 TIMES 2 MONTHS (FIRST AND LAST)             $_______________

LABEL SIZE ________ # OF LABELS-______________x    50 CENTS EACH            $_______________

START DATE________________   TOTAL ENCLOSED (ADD ABOVE LINES)            $_______________

NAME _________________________________________________________________

COMPANY NAME (IF APPLICABLE) ___________________________________________

STREET ADDRESS _______________________________________________________

CITY _________________________  STATE __________  ZIP CODE _______________

PHONE # ___________________  FAX ________________  EMAIL __________________

SOCIAL SECURITY # ____________________  DRIVERS LICENSE # _________________

*SOCIAL SECURITY NUMBER AND DRIVERS LICENSE NUMBER REQUIRED.

SIGNED ___________________________________________   DATE _______________

SIGNED ___________________________________________   DATE _______________

*PLEASE NOTE:  PERSONAL CHECKS WILL BE HELD FOR TWO WEEKS.  IT IS RECOMMENDED THAT YOU SEND A

MONEY ORDER OR CASHIER'S CHECK.

WHERE DID YOU HEAR ABOUT US?________________________________________________________________

Missing Children Awareness Foundation, Inc.

13094  95th Street North

Largo, FL  33773