Insurance Consumer Advocate Network: SPONSOR REGISTRATION FOR ATTORNEYS

Sponsor Registration Form

(Attorneys)

* Required field

Business name:

Attention:

Mailing address:

City:

State:

Zip:

Phone #1:

Phone #2:

Fax:

E-mail address:

Existing Web site URL:

Referred by:

Existing iCan Affiliate

Entry Level:

Standard Type Face ● No HTML Links …
$150.00 Listing Fee + $30.00 Mo ● Credit Card √

Charter Level:

Standard Type Face ● HTML Links …
$200.00 Listing Fee + $35.00 Mo ● Credit Card √

Founder Level:

Bold Type Face ● HTML Links …
$250.00 Listing Fee + $40.00 Mo ● Credit Card √

( Additional Listings add 50% Across-the-Board )

Listing Fee and Initial Monthly Fee Earned
Immediately Upon Publication !

√ Note: Discounts Available for “Cash” on an …
Annual ● Bi-Annual ● Lifetime Basis
( No Credit Cards )
Please Quote “Cash” Discount Prices

Please link my (our) listing to:

Above E-mail Above Website Do NOT Link

List any Professional Association Memberships
and/or Certifications here:

Terms and Conditions:

This agreement is entered into between the INSURANCE CONSUMER ADVOCATE NETWORK hereinafter referred to as "I-CAN" (158 Roxborough Drive, Branson West, MO 65737-8467 / 417-338-0950 / 417-338-0970 fax) and the service provider and/or supporter identified on the attached Registration Form hereinafter referred to as "Sponsor".

It is acknowledged that I-CAN is the sole proprietary owner and operator of an Internet Web site identified as www.ICAN2000.com. Said Web site is designed to be a Nationally Accessible and Locally Relevant source of information for Insurance Consumers. Web site visitors can access General information, published by I-CAN, on the negotiation and settlement of Auto, HomeOwner and/or Personal Injury Claims.

The I-CAN Web site is a means by which visiting consumers will identify "Local Help" Attorneys that could provide assistance in resolving Personal Injury, Bad Faith and/or Fraud claims that would arise involving Auto, HomeOwner and/or Commercial Insurance contracts. Sponsor affirms they are properly licensed and insured. Sponsor further affirms they will remain properly licensed and insured throughout the term of this agreement.

Sponsor acknowledges they have accessed a copy of the I-CAN Mission Statement published on the Web site which is, by reference, incorporated herein. Sponsor affirms they are in agreement with the goals and priorities set forth in the I-CAN Mission Statement. Sponsor understands that I-CAN will be publishing Sponsor's contact information on their Web site where it can be easily accessed by visiting consumers.

Sponsor also acknowledges that it is the intent of I-CAN to list only the most dedicated professionals on our Web site. As such, Sponsor acknowledges that I-CAN may (at the option of I-CAN) abrogate this agreement and refund sponsorship fees (pro-rata) in the event that Consumer Complaints to I-CAN (and the subsequent investigation of those complaints) reveal a pattern of conduct which I-CAN chooses not to endorse.

Sponsor also has the right to abrogate this agreement at any time and receive a pro-rata refund of sponsorship fees less a per listing re-programing fee.

Sponsor's Published Listing(s) will be Linked to Sponsor's own existing or future Web Page or Web Site or Full Page Display Ad (Sponsor provides "Copy") or pre-addressed e-mail templet at the option of Sponsor. Changes in listings and/or links will be done at no charge as requested within six (6) months of inception of this agreement. Later changes will be subject to a re-programing fee.

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OUR PLEDGE:

In addition to the Promises set forth above, I-CAN pledges to:

- Continue to Promote our Web site to consumers, both On-Line and Off-Line, to maintain our pattern of growth ("Hit" count verification available upon request)

- Continue active national recruitment of qualified "Local Help" sponsors who compliment our consumer advocacy efforts

- Network with, and support the efforts of, other agencies, associations and entities whose consumer advocacy goals are consistent with those set forth in the I-CAN Mission Statement

- Utilize our National e-mail data base of consumers to promote issue and political awareness on insurance related matters

- Issue Press Releases to stimulate and maintain consumer awareness on insurance related matters

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SPONSORSHIP FEES:

There are Four (4) Levels of Sponsor Participation . . .

1) Level One: "Trial Sponsor". The One-Time Fee is $200.00 per listing payable at the inception of this agreement for a Six Month "Trial" period. At the end of six months Sponsor has the option to either up-grade their participation level or allow this agreement to expire.

2) Level Two: "Sponsor". Fees are $300.00 per listing payable at the inception of this agreement and upon each annual renewal thereof. Level of sponsorship participation up-gradable on anniversary dates hereof. Monthly Payment Option: $90.00 down + $30.00 per month for 9 months (Credit Card Only).

3) Level Three: "Charter Sponsor". Fees are $500.00 per listing payable at inception of this agreement and then annually beginning with the Second renewal thereof. Second Year Sponsorship Fees are Waived for Charter Sponsors. There will be only 10 "Charter Sponsors" per service category - per state. Monthly Payment Option: $150.00 down + $50.00 per month for 9 months (Credit Card Only).

4) Level Four: "Founder". A "Founder" pays a one-time fee of $1,000.00 per listing at inception of this Sponsorship Agreement. All Future Sponsorship Fees for a "Founder" will be waived in perpetuity. There will be only 2 "Founders" per service category - per state.

5) Mutual: A "Mutual" Sponsor receives One Free Listing and Link to Sponsor’s web site.  In consideration of this Free Listing, "Mutual" Sponsor agrees to purchase no less than Seven (7) Residual Inherent Diminished Value Reports direct from I-CAN per year.

Sponsor's preferred level of participation is noted on the Registration Form.

This agreement shall take effect on the date it is "Accepted" by a duly authorized representative of I-CAN and shall automatically renew on the annual anniversary thereof (except "Trial" Sponsorships). Either party to this agreement may choose to not renew this agreement by providing the other party with written notice of their intent to not renew, said written notice to be conveyed by either receipted fax transmittal or registered mail and shall be conveyed no later than Thirty (30) days prior to the next scheduled renewal.

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I have read, understand and agree to the terms and conditions expressed herein.

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