Enlarge browser to full-screen. Print two copies of this agreement. Fill it out, and mail both copies to Sime~Gen Inc., P. O. Box 1244, Murray, KY 42071-0022, U.S.A. Alternatively, you may fax one copy of the signed form to (253) 541-5962. A representative of Sime~Gen Inc. will sign and return one copy to you.

Agreement Form for Reviewers

Name:__________________________________________________________________

Address:______________________________City:_______________________________

State/Province________________Postal Code:______________Country:______________

E-mail:_______________________________ Phone:_____________________________
                                                                         (emergencies only)
Fax:_________________________________AIM Handle:_________________________

How you want any copyright notice in your name to read:____________________________

I hereby affirm that I have read the Reviewers Agreement for Sime~Gen Inc. and simegen.com and agree to the terms therein.

Date:________________________________Year________

This form must be signed to be valid. Parental consent form must be filed in addition to this form if Reviewer is under 18 years of age.

Signature:_____________________________Witness:_____________________________

For Sime~Gen Inc:______________________Witness:_____________________________