Please review the following Agreement before you continue the application form. If you understand and agree to the acknowledgment statements on behalf of your organization, click on the "Click to Accept" button and continue the application process.

THE UNDERSIGNED AGREES AND REPRESENTS that it is fully and accurately described on the attached application; that it is an entity existing and doing business, lawfully, in the states where it does business; and that it is non-profit organization or is recognized as an organization that provides a public service.

THE UNDERSIGNED AGREES AND REPRESENTS that it has at least 100 individual members or supporters including employees.

THE UNDERSIGNED AGREES AND UNDERSTANDS that awards earned by participants in the Direct Awards Program will be directed to an Approved Organization, at the sole discretion of the participant. Once the choice of award direction is made, neither the Approved Organization nor the individual participant may change or alter the selection.

THE UNDERSIGNED AGREES AND REPRESENTS that any benefits received through the Qwest Direct Awards Program are available only when referrals are submitted and ordered through the Qwest Direct Awards Program sales centers (no other Qwest sales channel) and result in a completed sale and has service for 30 days or more. Amounts will be paid on a monthly basis.

THE UNDERSIGNED AGREES to publicize the Qwest Direct Awards program a minimum of three (3) times during the first month of the participation in the program and every quarter thereafter to members/supporters of the organization.

THE UNDERSIGNED AGREES to adhere to all program Terms and Conditions of the Qwest Direct Awards Program.

THE UNDERSIGNED ACKNOWLEDGES that the fund received from Qwest in the form of check is considered a commission check and is not a charitable contribution.

THE UNDERSIGNED ACKNOWLEDGES that Qwest has and retains the right to modify or terminate the program, or to remove or deny any participant/member/organization at any time, and from time to time, without notice and without liability to any eligible participant or Approved Organization.

THE UNDERSIGNED AGREES AND REPRESENTS that it will conduct its affairs in a professional manner and WILL NOT make any false, misleading or disparaging statements regarding any Qwest competitor or any other individual or organization as it relates to any activity associated with the Qwest Direct Awards Program.

For more Direct Awards Program Information, please visit www.qwestdirectawards.com or call 1 866-YOUCAN1 (1 866 968-2261).