As the authorized representative of the Act named above I hereby apply for Registration with CEE Worldwide on a Non Exclusive Agency Representation Basis. I give permission for the Agency to maintain my/our personal and business details in any Data Retrieval System (electronic or otherwise) and to distribute by any means necessary such of those details as may be necessary for the purposes of promoting and/or obtaining work for the Act or for meeting the requirements of any Legislation. The Agency may indicate they represent the Act in any and all promotional materials and advertising they deem necessary in order to promote the services of the Act.

I acknowledge reading the Terms of Business of the Agency contained on their web site, and agree that the Act will adhere to those terms and to those contained in any contract issued in relation to any and all work arising out of our relationship. I understand that if the Act should wish to cease being represented by the Agency I can give a minimum of 30 days notice in writing. I understand the act will be required to honor any and all contracts negotiated and accepted prior to the expiry of such written notice. I undertake to ensure that any ongoing commissions or other financial remuneration due is paid to the Agency promptly and in accordance with their Terms of Business.

I understand that all members of the Act are jointly and severally liable for any obligations arising out of this commitment.

I declare to the best of my knowledge and belief the information given above is true and complete.