Please complete the form below online, and then print it. Your signature MUST be manually added to the printed copy. You MUST complete all of the information below. Except for the phone number, ALL form fields are required. (And, if you don't enter your phone number, we won't be able to contact you, if something goes wrong.)

Mail the printed copy, and your check to:

PoolSolutions
P.O. Box 91418
Chattanooga, TN 37412

Is this email address yours, and only yours?)
Is email delivered to the address private, and readable ONLY by you or members of your immediate family? yes     no

(Are you an adult?)
Are you a legal adult in the country of your residence? yes       no

Are you in the pool business, in any way at all?)
Have either you, or anyone living with you in your primary residence, in the past 12 months, received, or do you expect, or does anyone living with your in your primary residence expect, in the next 12 months, to receive, more than $500 in salary, hourly wages, or other income as a result of work performed building, selling, making, servicing, promoting, advertising, regulating, inspecting, or describing swimming pools, spas, or hot tubs, or components of swimming pools, spas, or hot tubs, or products used to service swimming pools, spas, or hot tubs?
yes       no

(The subscription is just for you.)
I wish to subscribe to the PoolSolutions' PoolLetter and to have access to the protected areas of the PoolSolutions web site. I understand and agree that the information provided is confidential, and is only for use by myself and those living with me in my primary residence.

(Don't pass it on!)
I understand and agree that distribution of copies of the PoolLetter or of password protected web pages, by any means, whether electronic or otherwise, is a violation of this agreement and agree to pay any damages caused to PoolSolutions or to Ben Powell as a result of such unauthorized distributions, including legal expenses incurred by Ben Powell or PoolSolutions that might arise as a result of actions by anyone who received such copies from me. In particular, I acknowledge my liability for unpaid subscription fees due from parties to whom I have provided my password, or to whom I have forwarded the PoolLetter.

(Mistakes happen!)
I understand and agree that the information in the PoolLetter and on the PoolSolution's web pages reflects the opinion and experience of Ben Powell, and is, to the best of his knowledge, accurate and correct, but that it is subject to errors in both judgement and content. I understand and agree that I alone am responsible for any damages to me or to others which may result from any use by whomever of information provided to me, and that the limit of Ben Powell's and PoolSolution's liability shall be for a refund of the cost of subscription.

(Gotta tell the truth!)
I understand and agree that Ben Powell and PoolSolutions has a legitimate interest in obtaining accurate information about my name, adult status, and my relationship to the swimming pool and spa industry, and I assert that all the information I have provided here is both complete and accurate. I acknowledge my liability for any damages to Ben Powell, PoolSolutions, or other subscribers as a result of my providing false, inaccurate or incomplete information regarding my name, adult status or relationship to the swimming pool and spa industry.

(No SPAM)
I understand and agree that I will not release or provide to any third party, names or email addresses disclosed in the PoolLetter or the password protected web pages, and I accept responsibility for any damages to any and all parties which may result as a result of such a release or provision.

I am NOT in the pool or spa industry, and I have enclosed a personal* check for the correct amount the proper amount (see rates). I understand that if my application for a subscription is not accepted, the check will be destroyed.
*(I use personal checks to establish reasonable evidence that you are who you claim, and particularly, that you are an adult. Consequently, I do not accept money orders or any other form of payment that does not have your signature on it.)

Please make the check payable to "Ben Powell D/B/A Poolsolutions".

Signed: _______________________________

(By my signature above, and by my payment, enclosed, I assert that I both understand and accept all the terms this agreement with Ben Powell D/B/A PoolSolutions)

Date: _________________________________

Your name: ____________________________ (please print)

Notes and FINE PRINT:

I'll try to get you your password and User ID within 3 days of receiving your signed form and personal check)

Please submit ONLINE, too!
You don't have to, but it will work best if you ALSO submit the form online. (You still have to mail your check and signed copy.) Many of you have problems with entering your email addresses: receiving the automatic notification will assure you that it was correctly entered. Also, submission will lead you to a survey form that's your chance to have a say in what new material I add to the site, and what topics are included in the PoolLetter! I will also file the information in this form, so if I need to reply to an email message from you, I have some basic information to work from. (I will NOT give this information to anyone else!)

No credit cards? No money orders?
I'm not accepting credit cards for two reasons.

First, my credit card merchant account is not yet set up for Internet orders. They haven't complained about the charges made when I've sold a few of you test kits, feeders and the like. But, they are not likely to accept a bunch of charges for subscriptions.

Second, personal checks help me verify your identity. As I've explained before, I already have some pool industry folks receiving the free version of the PoolLetter under false names. As I collect your experiences — good or bad — with various pool products, I don't want 15 positive stories coming from the marketing manager of some new ‘revolutionary' pool product. I want to hear from real pool owners, and real pool service guys with real world experiences -- not from sales hacks hyping their product!

Rates and Dates! ($$$'s !!)

(see rates)

At present, all subscriptions and renewals extend to June 30, 2002.

I would greatly appreciate your suggestions for ways I can improve this process. I'm figuring this out as I go. If you see something I need to change, please tell me as soon as possible.