1% Agreement

Business Name

Owner's Name

Mailing Address (street address or PO box, city, state zip)

Physical Address (street address, city, state, zip)

Email Address

Website*

Business Phone

Cell Phone

Fax Number

Please see your Evergreen Legacy Fund program packet for your REQUIRED two signs.

I would like

Remittance envelopesA fact sheet for employeesCash register/IT assistance

Please tell us why you feel it is important to be a member of the Evergreen Legacy Fund. NOTE: We may use this quote for promotions as well as post it on our website and include in other media materials.

TERMS (please read and check all boxes)

I agree to remit funds monthly no later than 30 days after the month ended.I agree to openly advertise my business participating in the Evergreen Legacy Fund Program so that customers and/or clients are aware to choose not to participate.I will post a sign in at least two of the following locations: window, door, cash register, menu, other.I acknowledge that I am acting as a trustee on behalf of the Evergreen Legacy Fund and that I have an obligation to remit the funds collected according to the payment schedule selected above.I agree that, should this business change hands, or if I no longer wish to participate in the program, I MUST SUBMIT WRITTEN NOTICE OF THE TERMININATION OF THIS AGREEMENT to the Evergreen Legacy Fund.

*Your logo (and link) will appear on our website as long as your business is current.

SIGNATURE (type name and date)

Evergreen Legacy Fund 1% Agreement