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HONESTY Rx CARD

Organization Enrollment Application

Last Name (Contact Person)

First Name

Company Name Checks are issued in Organization's name.

Billing Address

Apt. or Suite #

City

State

Zip Code

State

City

Apt. or Suite #

Shipping Address

(If Different From Above)

Please do NOT use PO Boxes

Home Phone

Work Phone

Fax

Number of People You Reach Per Month

Additional Information

Tax ID or EIN#

Email Address

Sponsor Information

Sponsor's Name

Sponsor's Group #

Sponsor's Home or Cell Phone

Sponsor's Email

Honesty Rx Card Policies and Procedures (please read)

I have read, understand, and acknowledge the Honesty Rx, LLC Privacy Statement above.

Once we receive your enrollment form, our Dircector of Operations will contact you to welcome you to our Program.

Home | Enrollment | Contact Us

This Fundraising Program is Available For The Following Types Of Organizations:

1. Homeless Shelters

2. Churches

3. Pet Organizations

4. Schools

5. Hospitals

6. Free Clinics

7. Any Community Service/Non-Profit Organizations

Honesty Rx Card Policies & Procedures

I will not represent in any manner that I am an agent or legal representative of Honesty.

I understand that my donation will be the sum of .75 cents for each compensable claim that has been adjudicated with my individual group number.  I also understand that if a claim is considered uncompensable, or a claim is reversed or does not result in a paid claim for any reason, I will not be paid for that claim.  I also understand that some agencies require a 90 day period to process prescription claims.  Claims of this type will not be considered paid until such time as the agency submits payment.

This agreement does not constitute the sale or purchase of a franchise or of a business opportunity.

Both parties may terminate this agreement for any reason at any time, by giving written notice via mail, fax or email at the respective company contact point with Honesty Rx's being noted on the corporate website www.hrxcard.com

I understand that my personal tracking ID number (Group ID# on member card) will be activated by completing the Enrollment Application enclosed

In order to maintain a viable Marketing Program and to comply with changes in federal, state or local laws and economic conditions within the industry, Honesty may provide additional and modified Policies and Procedures for Organizations
from time to time, as well as to modify its Compensation Plan. Such Policies and Procedures, additions and modifications and Compensation Plan modifications, and all changes thereto, shall become a binding part of this Agreement.

I understand that no Attorney General or other regulatory authority ever reviews, endorses or approves any marketing plan or compensation plan, and I will make no such claim to others.

Your Organization shall utilize only those forms and promotional materials provided by Honesty Rx. Other marketing materials must be approved by Honesty Rx.

Honesty Rx Card will send a monthly report via mail with your total claims for that month. If you would like statement mailed please contact Customer Support. 504-715-2229

Fundraising Checks are mailed Quarterly on the 1st.

I will not make false or misleading statements about Honesty Rx. LLC

I agree that as a Organization Representative, this Agreement with Honesty grants me the limited authority to promote and market Honesty products and services which Honesty markets, subject to the terms and conditions established by Honesty from time to time.

Honesty conducts business in a professional and ethical manner and mandates that all, Customers and Honesty, be treated n the same manner.

Honesty reserves the right to use its judgment in deciding whether certain activities are improper, unethical or illegal. Honesty, in its sole discretion, will decide the appropriate corrective action if it determines that unprofessional, unethical or illegal activities exist and reserves the right to suspend or terminate any Organization's status, including but not limited to all Fundraising Donations.

This Agreement is governed by the laws of Alabama. The parties agree that any claim, dispute or other difference between them shall be exclusively resolved by binding arbitration pursuant to the Commercial Arbitration Rules of the American Arbitration Association with arbitration to occur at Dallas, Texas. Louisiana residents may choose to arbitrate in New Orleans.

HONESTY PRIVACY STATEMENT

Your privacy is important to HONESTY.  This privacy statement provides information about the personal information that HONESTY collects, and the ways in which HONESTY uses that personal information.

Personal information collection

HONESTY may collect and use the following kinds of personal information:

        [information about your use of this website (including preferences, pages visited, etc.]);] 
	[information that you provide using for the purpose of registering with the website

	[information about transactions carried out over this website  
	[information that you provide for the purpose of subscribing to the website services and]

	[any other information that you send to HONESTY.]

Using personal information

HONESTY may use your personal information to:

	[administer this website;]

	[personalize the website for you;]

	[enable your access to and use of the website services;]

	[publish information about you on the website;]

	[send to you products that you purchase;]

	[supply to you services that you purchase;]

	[send you statements and invoices;]

	[collect payments from you; and]

	[send you marketing communications.]

Where HONESTY discloses your personal information to its agents or sub-contractors for these purposes, the agent or sub-contractor in question will be obligated to use that personal information in accordance with the terms of this privacy statement.

In addition to the disclosures reasonably necessary for the purposes identified elsewhere above, HONESTY may disclose your personal information to the extent that it is required to do so by law, in connection with any legal proceedings or prospective legal proceedings, and in order to establish, exercise or defend its legal rights.

Securing your data

HONESTY will take reasonable technical and organisational precautions to prevent the loss, misuse or alteration of your personal information.

HONESTY will store all the personal information you provide on its secure servers.

[Information relating to electronic transactions entered into via this website will be protected by encryption technology.]

Cross-border data transfers

Information that HONESTY collects may be stored and processed in and transferred between any of the countries in which HONESTY operates to enable the use of the information in accordance with this privacy policy.

[In addition, personal information that you submit for publication on the website will be published on the internet and may be available around the world.]

You agree to such cross-border transfers of personal information.

Updating this statement

HONESTY may update this privacy policy by posting a new version on this website.

You should check this page occasionally to ensure you are familiar with any changes.

Other websites

This website contains links to other websites.

HONESTY is not responsible for the privacy policies or practices of any third party.

Contact HONESTY

If you have any questions about this privacy policy or HONESTY’S treatment of your personal information, please write to:

	by email to hrxcardsupport@gmail.com; or

	by post to P.O. BOX 180553 Mobile, AL 36618.

This privacy statement is based on a precedent created by employmentlawcontracts.co.uk and published by freenetlaw.com.

Non Disclosure Agreement

WHEREAS, parties contemplate discussions and analyses concerning Discount Pharmacy Cash Card Distribution; and
                                                                       
WHEREAS, in order to facilitate such discussions and analyses, certain confidential and proprietary technical and/or financial information may be disclosed between the parties orally or in writing:

THEREFORE, in consideration of the mutual covenants contained herein, and for other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the parties agree to the following:

1.	Each party will disclose Confidential Information to the other party for the sole purpose of discussing and analyzing Discount Pharmacy Cash Card Distribution

2.	“Confidential Information” as defined in this Agreement shall mean information of a confidential and proprietary nature that is disclosed by either party for the purposes of this Agreement and shall include confidential information relative to the disclosing party’s finances, assets, information technology (including computer programs, source codes and applications related thereto), formulas, patents, trademarks, trade secrets and other proprietary customer and pricing information and any other information designated by a party as confidential. The provisions of this Agreement shall also be deemed Confidential Information.

3.	The obligations imposed upon either party herein shall not apply to Confidential Information:
a.	which has already or subsequently becomes available to the public through no wrongful act; or
b.	which may be published prior to the date hereof; or
c.	which is already in the possession of the receiving party and not subject to an existing agreement of confidence between the parties; or
d.	which is received from a third party without restriction and without breach of this Agreement; or
e.	which is independently developed by the receiving party; or	
f.	which is disclosed pursuant to a requirement or request of a government agency, legal process, or an order of court.

4.	All Confidential Information furnished by one party to the other is considered loaned for use solely for the purposes described above and which may be requested or required pursuant to this Agreement, and shall be returned or destroyed by the receiving party to the disclosing party upon request by the disclosing party.  Upon written request the receiving party shall certify that it has destroyed or returned all copies of the Confidential Information in its possession.  Except as permitted or contemplated in this Agreement neither party shall disclose the other party’s Confidential Information to any third party without the other party’s prior written consent, and will protect the Confidential Information by using the same degree of care (but no less than a reasonable degree of care) as the recipient uses to protect its own similar confidential data.  Each party will use the Confidential Information only for the purposes described above.

5.	Each party may give Confidential Information to its employees, contractors and consultants, if those individuals need to know it to assist the recipient to accomplish the purposes described in Section 1 above.  Such individuals must first be bound by nondisclosure agreements with the recipient (which may be general in form) limiting their right to use such information to the purposes for which they receive it or agree to be bound pursuant to the terms of this Agreement.  The recipient will use reasonable commercial efforts to enforce the nondisclosure agreements this section requires.

6.	Each Party acknowledges that money damages may not be a sufficient remedy for any breach of this Agreement by the other Party (the “Breaching Party”) or such Breaching Party’s Representatives and that the non-breaching Party (the “Non-Breaching Party”) may suffer irreparable harm as a result of any such breach.  Accordingly, the Non-Breaching Party will also be entitled to seek equitable relief, including injunction and specific performance (without the requirement of any bond) as a remedy for any breach or threatened breach of this Agreement. The equitable remedies will not be deemed to be the exclusive remedies for a breach of this Agreement, but rather will be in addition to all other remedies available at law or in equity to the Non-Breaching Party.  In the event of litigation relating to this Agreement, if a court of competent jurisdiction determines that the Breaching Party or any of its Representatives has breached this Agreement, such Breaching Party will be liable for, and will pay to the Non-Breaching Party and its Representatives, the reasonable legal fees incurred by the Non-Breaching Party and the Non-Breaching Party’s Representatives in connection with such litigation (including any appeal relating thereto).

7.	For a period of two (2) years from the date of this Agreement, disclosed Confidential Information, unless written consent is otherwise granted by the disclosing party, shall be restricted to those employees and persons in the receiving party's organization with a need to know in order to perform services specifically requested by one party of the other in order to fulfill the purpose of this Agreement. Upon the termination of this Agreement or the purpose for entering into this Agreement each party agrees to continue to protect the Confidential Information provided by the other for so long as such information retains its confidential and proprietary nature.

8.	Recepient agrees to inform the providing Party of any unauthorized disclosure of Confidential information within 10 days of becoming aware of such disclosure.

9.	No furnishing of Confidential Information and no obligation hereunder shall obligate either party to enter into any further agreement or negotiation with the other or to refrain from entering into an agreement or negotiation with any other party.

10.	Each party, in disclosing information to the other party pursuant to this Agreement, warrants it has the right to disclose the Confidential Information it gives.

11.	This Agreement constitutes the entire agreement between the parties and supersedes any prior or contemporaneous oral or written representations with regard to the subject matter hereof.  This Agreement may be changed or modified only by written amendment signed by both parties.

12.	No party makes any representation, express or implied, as to the accuracy or completeness of the Confidential Information disclosed by it.

13.	Except as may be required by law Management Reps and Honesty Rx shall not disclose the fact of their discussions, or any information concerning their discussions to third parties and shall keep any such information in strict confidence.

14.	This Agreement will be governed by and construed in accordance with the laws of the State of Alabama without giving effect to principles of conflicts of laws.

15.	This Agreement may be executed in one or more counterparts, each of which shall be deemed an original but which together shall constitute the same instrument.  Each party agrees to be bound by its own telecopied or facsimiled signature, and agrees that it accepts the telecopied or facsimiled signature of the other party hereto.

16.	This agreement shall bind and inure to the benefit of the Parties and their succsessors and assigns.