The Netherlands Program

International Version Application - Not For Use In USA/Canada

- APPLICATION -

Name Address
Postal/Zip Code Town/City
County/State Country
. Email
How many places will you start with? This first place will be "under" your sponsor. Additional places become re-entries in the "universal matrix". .

Include Cash Payment In Banknotes With This Application.
USD$5 for each place.

Fill in the currency and the amount.

.
Payment may be made in any West European currency or in American, Canadian or Australian Dollars (for any other currency: please ask via Email info@jisl.com). The payment in a foreign currency must approximate the value of the amount in American dollars for the number of places at $ 5 (five American dollars). For example: a German applicant can send a DM 10 bank note per place. A Dutchman a bank note of ƒ 10,- etc. If the value of this payment is marginally more or less than the exact amount that has to be paid, JISL will settle the difference with the proceeds from the matrix.
The applicant wishes to apply for a "JISL Access Card" and agrees to pay $5 (five American dollars) per month. Applicant wishes to participate in the 3 x 11 matrix and authorises JISL to settle -if possible- monthly payments with the proceeds of this matrix. Applicant knows that he/she can cancel this agreement just by not paying the monthly rates. Applicant will receive the "JISL Access Card" as soon as to total of the monthly payments and the proceeds of the matrix exceed the amount of one hundred American dollars (if applicant is paying for more places in the universal matrix all those payments and proceeds will count towards this amount). On dispatch of the card JISL will deduct thirty five American dollars from the applicant's balance as the annual fee for the card.
Date, _________________________19

Signature of applicant.

The sponsor of this applicant is:

AQBS201ZY98

Please send this application to: "FDG" - Postbox 6403 - 5600 HK Eindhoven - The Netherlands