Common use of Subscription Particulars Clause in Contracts

Subscription Particulars. The aggregate number of Units subscribed for is . ------------------------- The Preferred Shares, Short Term Warrants and Two Year Warrants are to be registered in the name of: ------------------------------------------------------------ (if space is insufficient, attach a list) The certificates representing the Preferred Shares, Short Term Warrants and Two Year Warrants are to be delivered to: ------------------------------------------------------------ ------------------------------------------------------------ at its office at: ------------------------------------------------------------ ------------------------------------------------------------ Contact Name and Number: If the Purchaser is signing as agent for a principal and not as agent for a fully managed account, the name and address of the beneficial purchaser is: ------------------------------------------------------------ ------------------------------------------------------------ (if space is insufficient, attach a list) DATED at this day of , 2003. -------------------- ----------- ------------------- ------------------------------------------ Name of Purchaser (please type or print) By: ---------------------------------------- (Signature of Authorized Representative) ---------------------------------------- (Name of Person Signing) ---------------------------------------- Office or Title ---------------------------------------- ---------------------------------------- Address of Purchaser

Subscription Particulars. (a) The aggregate number of Units the of Common Shares being subscribed for is ______________ . ------------------------- The Preferred Shares, Short Term Warrants and Two Year Warrants aggregate price of the Common Shares being subscribed for is $ _______________. (b) The Common Shares are to be registered in the following name ofand address: ------------------------------------------------------------ _______________________________________________________________________________________________________ _______________________________________________________________________________________________________ (if space is insufficient, attach a list) (c) The certificates certificate representing the Preferred Shares, Short Term Warrants and Two Year Warrants are Common Shares is to be delivered to: ------------------------------------------------------------ ------------------------------------------------------------ _______________________________________________________________________________________________________ _______________________________________________________________________________________________________ at its office at: ------------------------------------------------------------ ------------------------------------------------------------ ____________________________________________________________________________________________ _______________________________________________________________________________________________________ _______________________________________________________________________________________________________ Contact Name and Name: ____________________ Contact Number: :____________________ (d) If the Purchaser is signing as agent for a principal and not as agent for a fully managed account, the name and address of the beneficial purchaser is: ------------------------------------------------------------ ------------------------------------------------------------ _______________________________________________________________________________________________________ _______________________________________________________________________________________________________ _______________________________________________________________________________________________________ _______________________________________________________________________________________________________ (if space is insufficiente) The Purchaser owns or has control or direction over the following number of securities of the Company. Shares: ____________________ Warrants: ____________________ Dated at ____________________ , attach a list) DATED at this _______day of ____________________, 20032002. -------------------- ----------- ------------------- ------------------------------------------ Address of Purchaser: ____________________________________________________________________________________________ Name of Purchaser (please type or print): ____________________________________________________________________________________ Witness (if an individual) By: ---------------------------------------- (Signature of Authorized Representative) ---------------------------------------- (Name of Person Signing) ---------------------------------------- Office or Title ---------------------------------------- ---------------------------------------- Address on behalf of Purchaser) Witness (if an individual) Office, Title of Other Authorization (if not an individual)

Subscription Particulars. (a) The aggregate number of Units subscribed for is . ------------------------- _________________________. (b) The Preferred Shares, Short Term Series B Warrants and Two Year Additional Warrants are to be registered in the name of: ------------------------------------------------------------ -------------------------------------------------------------------------- (if space is insufficient, attach a list) (c) The certificates representing the Preferred Shares, Short Term Series B Warrants and Two Year Additional Warrants are to be delivered to: ------------------------------------------------------------ ------------------------------------------------------------ -------------------------------------------------------------------------- -------------------------------------------------------------------------- at its office at: ------------------------------------------------------------ ------------------------------------------------------------ -------------------------------------------------------------------------- -------------------------------------------------------------------------- Contact Name and Number: -------------------------------------------------------------------------- (d) If the Purchaser is signing as agent for a principal and not as agent for a fully managed account, the name and address of the beneficial purchaser is: ------------------------------------------------------------ ------------------------------------------------------------ -------------------------------------------------------------------------- -------------------------------------------------------------------------- (if space is insufficient, attach a list) DATED at ___________ this day of March, 20032002. -------------------- ----------- ------------------- ------------------------------------------ ---------------------------------------------- Name of Purchaser (please type or print) By: ---------------------------------------- (Signature of Authorized Representative) ---------------------------------------- (Name of Person Signing) ---------------------------------------- Office or Title ---------------------------------------- ---------------------------------------- -------------------------------- -------------------------------- Address of Purchaser