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All of the information in the signup form is required. We use this data for demographics to present to potential advertisers who may be looking to advertise in your area.

Name

First Name:

Last Name:

Contact Information

Daytime Phone:

Nighttime Phone:

E-Mail Address:

Home Address

Address (line 1):

Address (line 2):

City:

State/Province:

Zip/Postal Code:

Work Address

Company/School Name:

Address (line 1):

Address (line 2):

City:

State/Province:

Zip/Postal Code:

Vehicle Information

* Suggested but not required.

* Drivers License Number:

* Auto Insurance Company:

* Auto Insurance Number:

Car Make:

Car Model:

Year of Car:

Car Color:

Do you own or lease?

Lein Holder:

Miles driven per month:

Age:

Gender:

male female

Race/Ethnicity:

African American
Asian
Hispanic

Native American
White
Other

Marital Status:

single married

Children:

Household Income:

Employment Status:

Work Full-Time
Work Part-Time
Not Employed

Full-Time Student
Part-Time Student
Full-Time Childcare/Homemaker

Occupation:

Industry:

Terms & Conditions

Terms and Conditions

Participation in this program is on an at will basis and Ad-Wraps.com reserves the right to select participants based on its current business need and to modify or terminate this offer at any time.  Criteria for selection may include, but is not limited to, driving habits and lifestyle.  Before entering into an agreement with any person, Ad-Wraps.com reserves the right to review DMV records.  Any false statements or withholding of information is grounds for termination from the agreement.

1. How to sign up/selection process

As a potential driver you need to complete the questionnaire on the Ad-Wraps.com site. Your answers will provide us with information about you including where you live and work, where you drive, and where you park.  Ad-Wraps.com will compile the applications into a database of potential drivers. Our advertising clients will select the drivers that best meet their desired needs based on the information you provide.

2. Eligibility

You must possess a valid U.S. driver's license. Ad-Wraps.com will run Motor Vehicle Record, Criminal Background and Credit checks.

3. General Conditions

You are also responsible for fueling your vehicle and for the insurance. If you are selected to receive one of our cars, we pay for the lease and for all scheduled maintenance and repairs on the vehicle.

4. Conduct and Rules

As a selected driver, Ad-Wraps.com and our advertisers are counting on you to continue to drive and live the way you said you would on the questionnaire. Therefore it is important to adhere to the following rules and comply with appropriate conduct.

You must:

· Drive approximately the number of miles you said you would.

· Keep the interior and exterior of your vehicle clean.

· Be the primary driver of the vehicle.

· Contact Ad-Wraps.com to report any accidents, moving violations, or problems with the wrap.

These are only general rules of conduct. If you are selected for the program, we will send you a driver's contract that describes to you all of the legally binding terms and conditions.

5. Selected Drivers

An AdWraps representative will notify potential Ad-Wraps.com drivers as soon as you are selected by one of our advertisers.

· Selected drivers must sign a Drivers Contract that specifically outlines all terms and conditions of your contract with Ad-Wraps.com.

· You will also receive a Drivers Handbook that will provide you with information what do in case of an accident and other Ad-Wraps.com policies and procedures.

6. How to turn in your car

You will be notified by an Ad-Wraps.com representative To let you know where and when you will need to return your AdWraps or where and when we will take the advertisement off of your vehicle. Specific details on each program are outlined in a "Driver Contract Agreement" that you will receive once you are selected for the program.

7. Use of data you provide.

To fulfill our business objective of providing our registrants with free cars, we will need to obtain personally identifiable information from you or about you. Such personally identifiable information may include your name, home address, e-mail address, telephone number, income, credit references, etc. The information we receive about you or from you may be used by us or shared by us with our corporate affiliates, agents, vendors and others to help process or complete a transaction; to comply with any law, regulation, audit or court order; to help improve our Web site or the products or services we offer; for research; to better understand our customers' needs; to develop new offerings; and to alert you to new products and services in which you may be interested. We believe that knowing more about you can enable us to serve you better.

For more details about how we protect your information, please see our privacy policy.

By submitting this application, I am agreeing with the terms of the program and I understand that Ad-Wraps.com cannot guarantee that I will be accepted to participate in the program.
	YES, I have read and agree to the Terms and Conditions of the AdWraps program, and I want to participate in the program.
	NO, I have read the Terms and Conditions of the AdWraps program and decline to participate. Please do not contact me further in regard to this program.

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