NEW INDEPENDENT RETAIL SALES REPRESENTATIVE APPLICATION-AGREEMENT

APPLICANT INFORMATION (Applying Representative)

Social Security Number or Federal Tax ID # _____________________________ (Prior approval is required to operate as a corporate entity.)
Legal Name (Last) ____________________________________________ (First) ____________________________ (Initial) __________
Preferred Name (Last) _________________________________________ (First) ____________________________ (Initial) __________
(SPOUSE OF CURRENT SILPADA DESIGNS REPRESENTATIVE IS NOT ELIGIBLE TO BECOME A SILPADA DESIGNS REPRESENTATIVE)

Mailing Address ________________________________________________________________________________________________________

City/Town ____________________________________ State _________________ Zip ___________ County _____________________________
Day Phone (_________)_________________ Night Phone (_________)____________________ Other Phone (_________)__________________
Fax Number (_________)___________________ Email Address _________________________________________________________________
Do you currently represent or consult with any other direct selling company(s) or sell other jewelry?  YES  NO
If Yes, with which company(s) are you currently affiliated? _______________________________________________________________________
What is your position/title with the company?  Independent Representative  Other ____________________________________________
Describe the primary product line sold by the above mentioned Company(s) _______________________________________________________

SHIPPING INFORMATION (If mailing address above is a P.O. Box, include a street address here for shipping.)
Shipping Address (No P.O. Boxes) ____________________________________________________________________________________________
City/Town __________________________________ State ___________________ Zip _________________ County ________________________
Fax Number (_________)______________________ Email Address _______________________________________________________________

SPONSOR INFORMATION (Existing Silpada Designs Representative)

Sponsor’s Silpada Representative Number ____________________________________
Name of Representative (Last) ____________________________________ (First) ______________________________ (Initial) _______________
Mailing Address __________________________________________________________________________________________________________
City/Town ________________________________________________________ State ______________________ Zip _______________________
Day Phone (________)_____________________ Night Phone (________)_____________________ Other Phone (________)_________________

I AGREE THAT THE ABOVE INFORMATION IS TRUE AND ACCURATE, THAT I HAVE READ AND AGREE TO BE BOUND BY THE TERMS AND
CONDITIONS OF THIS APPLICATION-AGREEMENT AS SET FORTH ON BOTH PAGES OF THIS DOCUMENT AND THAT THIS DOCUMENT HAS
NOT BEEN ALTERED OR MODIFIED IN ANY WAY. I AGREE THAT SILPADA DESIGNS, INC. IS AUTHORIZED TO VERIFY THE INFORMATION
I HAVE PROVIDED. THIS APPLICATION IS SUBJECT TO REVIEW AND ACCEPTANCE BY SILPADA DESIGNS, INC. ACCEPTANCE OF THIS
APPLICATION IS ONLY ACKNOWLEDGED BY SILPADA DESIGNS, INC. UPON ITS ISSUANCE OF AN AUTHORIZED SILPADA DESIGNS
REPRESENTATIVE NUMBER (SDR #) AND BUSINESS SIGN-UP KIT TO THE APPLICANT NAMED HEREIN. SDFAPP-09 ver 7/09

Applicant’s Signature Required Date

PAYMENT OPTIONS PAYMENT SUMMARY

Credit/Debit Card Authorization (must be filled out completely) Total Cost of Kit (from Kit Order Form) $________
 MasterCard  VISA
Shipping & Handling* $________
No other credit/debit cards accepted

Card # _______-_______-_______-_______ Exp. Date _______

*Add Applicable Shipping & Handling Charge:
Name of Cardholder ___________________________________
$15 United States
Cardholder acknowledges that her/his credit/debit card may be charged prior to the
actual shipment date of the item(s) purchased. Except in the case of back orders, items $25 Alaska, Hawaii, APO/FPO, Puerto Rico,
will normally be shipped within 7 days of the date the card is charged. Guam, US Virgin Islands & US Territories

Signature ____________________________________________ Subtotal $________

Local Sales Tax (Rate ___% x Subtotal) $________
Certified Check/Money Order # _________________________
TOTAL AMOUNT ENCLOSED $________
Personal Checks Are Not Accepted (Subtotal + Local Sales Tax)

Sign and Date the FRONT of this Application-Agreement. Remit along with your Payment, Sign-up Kit Order Form, and
Independent Representative Information Form (with signed W-9) to the address below. Your Application will not be
considered without all of the above complete & accurate items. Please allow 5-7 business days from receipt by Silpada Designs
for your business Sign-up Kit to ship.
Mail: Silpada Designs, Inc., 11550 Renner Blvd., Lenexa, KS 66219-9600
Fax: 913.851.7735 Phone: 913.851.7757 or 1.888.745.7232 (toll-free in the US)

WHITE - HOME OFFICE COPY YELLOW - APPLICANT COPY SDFAPP-09

Upon acceptance of this Application by Silpada Designs, Inc. (Silpada or Company), as evidenced and acknowledged by Silpada’s issuance of an authorized Silpada Designs Representative Number (SDR #)
and business Sign-up Kit to the Applicant, this application becomes a binding legal agreement and the applicant will become an authorized Silpada Representative (hereafter SDR or Representative.) The
Company’s Statement of Policies and Procedures (Procedures) and Business Reference Guide (BRG) are incorporated herein by this reference and made a part of this Agreement.
Independent Contractor Relationship. Silpada pursuant to the terms of this Independent Retail Sales Agreement (Agreement) hereby retains the Representative’s services to market and sell
Company’s products to the public subject to Company’s approval and Representative’s adherence to Company’s operational guidelines. The parties intend that their relationship shall be as independent
contractor and not as employer/employee. Representative shall, at her/his own expense, make, execute or file all such reports and obtain such licenses as are required by law or public authority with respect
to this Agreement and/or the receipt, holding, selling, distributing or advertising of Company products. The Representative hereby certifies to the Company that she/he is duly authorized to work in the
United States, U.S. Territories, or U.S. Military Bases. With special permission granted by the Company in writing, the Company may allow a SDR to form a single member limited liability company or single
shareholder corporation in which to conduct her/his Silpada business. Such company must be preapproved and meet the restrictions outlined in the Company’s Procedures.
Limited Restrictions & Duties. Representative is free to sell Silpada products and recruit independent Representatives anywhere in, but only in, the United States, U.S. Territories, and U.S. Military
Bases. The BRG and Policies and Procedures, which may be unilaterally modified or amended from time to time by the Company, form the operational guidelines of the Company. Representative agrees that
without the express written consent of the Company, it shall be a violation and breach of this Agreement for Representative to (a) represent, sell or promote, directly or indirectly, any other line(s) of jewelry,
Watches or Belts, or (b) sell, promote or display, directly or indirectly, any jewelry, Watches or Belts not purchased directly from the Company, or (c) represent, sell, promote or display, directly or indirectly,
any jewelry, Watches, or Belts as a Company product if they are not a Company product, or (d) be employed by, directly or indirectly, consult with or be an advisor to, whether paid or unpaid, any other
direct sales company or entity or direct sales personnel or (e) sell Company products to or through retail stores or other fixed commercial outlets or (f) fail to follow or breach in any significant manner any
provision of the BRG and Procedures. Further, Representative shall not directly, or indirectly whether through spouses or other affiliated third parties or entities, solicit, show, promote, market or sell any non-
Silpada products and/or services to other Silpada Representatives, or solicit or recruit prospective Representatives and/or Customers on behalf of any other company at a Silpada Home Show, demonstration,
or book party or at any Silpada Designs company event or conference; nor shall Silpada products be shown or sold at a non-Silpada Home Show or demonstration. Further, a Representative shall not use any
Silpada intellectual property, SDR Resources Business Suite applications, Silpada products, printed or Web-based photographs, marketing materials or forms, or its registered name, prestige or drawing power
in conjunction with or in support of non-Silpada activities or to solicit, show, promote, market or sell any non-Silpada products and/or services without prior written authorization. Further, Representatives
at the Sterling Manager’s rank (or above) of the Silpada Career & Compensation Plan may not directly or indirectly or on behalf of any other person(s) or entity sell or recruit for or manage or own any other
direct sales company(s).
World Wide Web Restrictions. With prior written approval of Silpada Designs, Representative shall have the opportunity to maintain a personalized page(s) on the Silpada Corporate Web Site: Silpada.
com and/or My Silpada.com, the only authorized and permitted Silpada World Wide Web site(s). Representative further agrees that without the express written consent of the Company, it shall be a breach
of this Agreement for Representative to operate on the internet in violation of Silpada Designs Corporate Web Policy as detailed in the Procedures.
Certification Fees. Representative hereby agrees to pay a non-refundable initial certification fee, as designated by the Sign-up Kit of Representative’s choice, to the Company in order to qualify as a
Company Representative. The initial certification fee and annual renewable recertification fee is non-refundable and will offset in part the cost of the products and services available to the Representative.
In addition, a Silpada Representative Sign-up Kit of Supplies and Materials will be provided to each new Representative upon the payment of the initial fee and will be updated as deemed necessary by the
Company, in accordance with the Business Reference Guide. Representatives are not required to carry inventory of Silpada Designs products or sales aids. Therefore, Silpada does not offer a “buy back” policy
for such purchases. Product samples, including Sign-up Kits, may be exchanged, replaced or refunded under the guidelines of the Silpada Designs Guarantee.
Compensation. As compensation for services provided hereunder, Representative shall be paid in accordance with Company’s Career & Compensation Plan (Compensation Plan) which is included in the
Business Reference Guide. Company may unilaterally, upon 30-day notice to Representative, modify or amend such Compensation Plan.
Customer Disputes. Representative is responsible for resolving disputed charges, insufficient funds checks, and stop-payment checks from customers. All disputed charges will be the responsibility of the
Representative.
Term. This Agreement shall run for a period of one year from the effective date hereof whereupon it may be renewed only with the mutual agreement of both parties for successive periods of one year each
upon the payment of the applicable recertification fee and the execution of a Re-certification Application-Agreement. Company retains the right to reject the initial certification application or the
re-certification application of any Representative for any reason. No spouse of an SDR may become a Representative.
Termination. This Agreement may be terminated: (a) at the end of its term without notice; (b) by the Representative for any reason upon written notice to the Company; (c) by the Company for any reason
upon written notice in which case, if such termination is not for cause, Representative is entitled to a pro-rated refund of the current year’s certification fee (which is defined as the “non-jewelry” portion of
the certification). The pro-ration will be calculated on the basis of a 365-day year; (d) by the Company for cause with written notice whereupon the current year’s certification fee will not be refunded to the
Representative.
Confidential Information. The Company deems all Company printed, Web-based, audio and video marketing materials, training manuals, training tapes and/or CD Roms, newsletters, agreements,
business forms, names and address lists of other Silpada Representatives, customer lists, trade secrets, pricing information, knowledge as to sources, and customer purchasing histories, to be confidential
and/or proprietary to the Company whether these items are specifically marked “confidential” or not. Representative may not use the names and address lists of other Silpada Representatives or Customers
to solicit, promote, market, or sell non-Silpada products and services. The parties acknowledge and agree that Company has legally protectable interests in, among other things, maintaining confidential
its business and commercial information, including but not limited to all confidential and proprietary information itemized above. Representative covenants and agrees that at no time will Representative
directly or indirectly divulge, disclose or communicate to any person, firm or corporation in any manner whatsoever any information of any kind, nature or type concerning any matters affecting or relating
to the business of Company including, without limitation, Company marketing and training materials, manuals and guides, agreements or business forms, the names and addresses of its other Silpada
Representatives, customers, the prices it obtains or has obtained or for which it sells or has sold its services or products, cost information, knowledge as to sources of business, the purchasing history of its
other Silpada Representatives or customers, computer data with respect to its Representatives, customers and suppliers, goods and services purchased by Company, goods and services sold by Company
to its customers, including the type and value thereof and quantity of items, credit history of its Representatives or customers or any other information of, about or concerning the business of Company, its
manner of operation, its plans, processes or other data of any kind, nature or description without regard to whether any or all of the foregoing matters would be deemed confidential material or important.
Representative acknowledges and agrees that all such information is confidential and gravely affects the successful conduct of Company’s business, its goodwill and that any breach of the terms of this
Agreement shall be deemed a material breach hereof. Representative will not use or describe such confidential information except as authorized by Silpada. The Representative agrees that while under
contract with the Company and for a period of 24 months thereafter, whether termination of Agreement is occasioned by Company, Representative or by mutual agreement, or whether Agreement is
terminated with or without cause, to directly or indirectly, for herself/himself or in or on behalf of any other party or entity, solicit or recruit or cause any other person or entity to solicit or recruit any
employee of Company or any Independent Silpada Sales Representative either under contract with Company (or who has been under contract with the Company in the six months prior to termination of
this Agreement) to any such business.
Remedies. Representative acknowledges that any breach, violation or evasion by Representative of the terms of this Agreement will result in immediate and irreparable injury and harm to Company
and will cause damages to Company in amounts difficult to ascertain and for which remedies at law may be inadequate. In such event Company shall be entitled to pursue any lawful remedies whether
at law or equity including, but not limited to, the remedies of injunction, and specific performance or either or both of such remedies. In the event of any breach, violation or evasion of this Agreement by
Representative, Representative agrees to pay all costs of Company to enforce or protect its rights including all reasonable attorney fees and court costs.
No Waiver. Failure by Company or Representative to insist upon or enforce any of their rights shall not constitute a waiver thereof, and nothing shall constitute a waiver of Company’s or Representative’s
right to insist upon strict compliance with the provisions hereof.
Kansas Law. This Application-Agreement shall be governed, construed and enforced under the laws of the State of Kansas.
Entire Agreement. The terms and conditions of this Application-Agreement represent the entire agreement between the Representative and Silpada and include no others and shall supercede any other
representations, discussions, prior understandings or agreements between the parties. No oral modification hereof shall be binding upon the parties, and any modification shall be in writing and signed by
the parties.
Representative Understanding. Representative has read and understands all the terms and conditions of this Agreement, is 18 years old or older, executes this Agreement of her/his own free will
intending to be bound by this Agreement.
Severability. Should any term of this Agreement be determined to be invalid or unenforceable, the remaining provisions hereof will be unaffected.
Conflict. In the event of any conflict between a provision of this Agreement and the BRG or Policies and Procedures, the provision of the BRG or Policies and Procedures most recent in time
will govern.
Ver 7/09 7/09
 NEW INDEPENDENT RETAIL SALES REPRESENTATIVE APPLICATION-AGREEMENT
APPLICANT INFORMATION (Applying Representative)
Social Security Number or Federal Tax ID # _____________________________ (Prior approval is required to operate as a corporate entity.)
Legal Name (Last) ____________________________________________ (First) ____________________________ (Initial) __________
Preferred Name (Last) _________________________________________ (First) ____________________________ (Initial) __________
(SPOUSE OF CURRENT SILPADA DESIGNS REPRESENTATIVE IS NOT ELIGIBLE TO BECOME A SILPADA DESIGNS REPRESENTATIVE)

Mailing Address ________________________________________________________________________________________________________

City/Town ____________________________________ State _________________ Zip ___________ County _____________________________
Day Phone (_________)_________________ Night Phone (_________)____________________ Other Phone (_________)__________________
Fax Number (_________)___________________ Email Address _________________________________________________________________
Do you currently represent or consult with any other direct selling company(s) or sell other jewelry?  YES  NO
If Yes, with which company(s) are you currently affiliated? _______________________________________________________________________
What is your position/title with the company?  Independent Representative  Other ____________________________________________
Describe the primary product line sold by the above mentioned Company(s) _______________________________________________________

SHIPPING INFORMATION (If mailing address above is a P.O. Box, include a street address here for shipping.)
Shipping Address (No P.O. Boxes) ____________________________________________________________________________________________
City/Town __________________________________ State ___________________ Zip _________________ County ________________________
Fax Number (_________)______________________ Email Address _______________________________________________________________

SPONSOR INFORMATION (Existing Silpada Designs Representative)

Sponsor’s Silpada Representative Number ____________________________________
Name of Representative (Last) ____________________________________ (First) ______________________________ (Initial) _______________
Mailing Address __________________________________________________________________________________________________________
City/Town ________________________________________________________ State ______________________ Zip _______________________
Day Phone (________)_____________________ Night Phone (________)_____________________ Other Phone (________)_________________

I AGREE THAT THE ABOVE INFORMATION IS TRUE AND ACCURATE, THAT I HAVE READ AND AGREE TO BE BOUND BY THE TERMS AND
CONDITIONS OF THIS APPLICATION-AGREEMENT AS SET FORTH ON BOTH PAGES OF THIS DOCUMENT AND THAT THIS DOCUMENT HAS
NOT BEEN ALTERED OR MODIFIED IN ANY WAY. I AGREE THAT SILPADA DESIGNS, INC. IS AUTHORIZED TO VERIFY THE INFORMATION
I HAVE PROVIDED. THIS APPLICATION IS SUBJECT TO REVIEW AND ACCEPTANCE BY SILPADA DESIGNS, INC. ACCEPTANCE OF THIS
APPLICATION IS ONLY ACKNOWLEDGED BY SILPADA DESIGNS, INC. UPON ITS ISSUANCE OF AN AUTHORIZED SILPADA DESIGNS
REPRESENTATIVE NUMBER (SDR #) AND BUSINESS SIGN-UP KIT TO THE APPLICANT NAMED HEREIN. SDFAPP-09 ver 7/09

Applicant’s Signature Required Date

PAYMENT OPTIONS PAYMENT SUMMARY

Credit/Debit Card Authorization (must be filled out completely) Total Cost of Kit (from Kit Order Form) $________
 MasterCard  VISA
Shipping & Handling* $________
No other credit/debit cards accepted

Card # _______-_______-_______-_______ Exp. Date _______

*Add Applicable Shipping & Handling Charge:
Name of Cardholder ___________________________________
$15 United States
Cardholder acknowledges that her/his credit/debit card may be charged prior to the
actual shipment date of the item(s) purchased. Except in the case of back orders, items $25 Alaska, Hawaii, APO/FPO, Puerto Rico,
will normally be shipped within 7 days of the date the card is charged. Guam, US Virgin Islands & US Territories

Signature ____________________________________________ Subtotal $________

Local Sales Tax (Rate ___% x Subtotal) $________
Certified Check/Money Order # _________________________
TOTAL AMOUNT ENCLOSED $________
Personal Checks Are Not Accepted (Subtotal + Local Sales Tax)

Sign and Date the FRONT of this Application-Agreement. Remit along with your Payment, Sign-up Kit Order Form, and
Independent Representative Information Form (with signed W-9) to the address below. Your Application will not be
considered without all of the above complete & accurate items. Please allow 5-7 business days from receipt by Silpada Designs
for your business Sign-up Kit to ship.
Mail: Silpada Designs, Inc., 11550 Renner Blvd., Lenexa, KS 66219-9600
Fax: 913.851.7735 Phone: 913.851.7757 or 1.888.745.7232 (toll-free in the US)

WHITE - HOME OFFICE COPY YELLOW - APPLICANT COPY SDFAPP-09