Please complete this form to apply as a Touchplan Referral partner. Call (617) 362-7016 if you have any questions. Thanks. Referral Partner Application Company* Name* First Last Title* Phone*Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Email* Enter Email Confirm Email Website* Business Type* Individual - non-business Proprietor Partnership Corporation Classification*How would you classify yourself? (check all that apply) Individual - non business Influencer Blogger / Forum Consultant Retailer VAR MSP System Integrator Distributor OEM Developer Chain or Franchise Training Mail Order E-Commerce Target AudienceIf a blogger, influencer, consultant, reseller, etc. - do you target a particular company type?Projected RevenueAnticipated revenues this year? If applicable. Geography*What geographical area(s) do you serve (check all that apply) Does not apply Local (50 mile) State Wide Regional (multiple states) National International Relationships & CertificationsPlease list primary vendors you have a formal relationship with (reseller agreements). Include key certifications.Similar or Complimentary ProductsList other products you work with that are similar or complimentary to our products.Value Added ServicesProvide a description of your primary "Value Added" services (integration, training, custom development, consulting, etc.) - if applicableDateSelect today's date MM slash DD slash YYYY Consent*Referral Agreement This agreement (the “Agreement”) is between Moca Systems, Inc., dba Touchplan (“Touchplan”) and you, the referral partner (“Affiliate”) and establishes the terms and conditions for participation in the TouchPlan Affiliate Program (the “Program”). By completing and submitting this Affiliate application, Affiliate agrees to the following: Referrals During the term of this Agreement, Affiliate agrees to use reasonable commercial efforts to promote and refer sales prospects who may be interested in purchasing Touchplan products and services to Touchplan in accordance with the terms and conditions contained herein. Relationships Affiliate is an independent contractor, and may only perform hereunder on a strictly non-exclusive basis. Affiliate is not an agent or legal representative of Touchplan for any purpose, and has no authority to act for, bind or commit Touchplan. Term, Limitations, Termination The term of this Agreement is twelve (12) months from the date of application acceptance by Affiliate and Touchplan. This Agreement shall automatically renew on each subsequent year for a one-year term, unless it is terminated earlier in accordance with this Agreement. Touchplan or Affiliate may terminate this Agreement without cause at any time upon thirty (30) days written notice, except that neither the expiration nor earlier termination of this Agreement shall release either party from any obligation which has accrued as of the date of termination. Affiliate understands and agrees to the following causes for immediate termination: Affiliate shall not sell, advertise, or engage in pornography, phishing scams, spamming, illegal business practices, or that include any material infringing on National or International Copyright. Affiliate shall not operate any coupon site in connection with any Touchplan product or offering (either as an Affiliate, or posted on coupon sites), and shall not purchase any adwords, pay-per-click, or other similar marketing tools that include the Affiliate link Affiliate may only include the Affiliate link in organic links from Affiliate’s own website, social media accounts, forums, or emails are acceptable. Affiliate will not promote with any type of mass email spam (newsletters, social posts, etc., using your own registered users are not considered spam) Touchplan may, from time to time, give Affiliate written notice of amendments to this Agreement. Any such amendment will automatically become a part of this Agreement ten (10) days from the date of the notice unless otherwise specified in the notice. Use of Touchplan Trademarks Affiliate acknowledges the following: Touchplan owns all right, title and interest in the Touchplan names and logotypes. Touchplan is the owner of certain other trademarks and trade names used in connection with certain product lines and software. Affiliate will acquire no interest in any such trademarks or trade names by virtue of this Agreement, its activities under it, or any relationship with Touchplan. During the term of this Agreement, Affiliate may indicate to the trade and to the public that it is an authorized affiliate of Touchplan. Affiliate may also use the Touchplan trademarks and trade names to promote Touchplan products if done so in strict accordance with Touchplan guidelines. Affiliate will not adopt or use such trademarks or tradenames, or any confusingly similar word or symbol, as part of its company name or allow such marks or names to be used by others. At the expiration or termination of this Agreement, Affiliate shall immediately discontinue any use of the Touchplan and Touchplan names or trademarks or any other combination of words, designs, trademarks or trade names that would indicate that it is or was an authorized affiliate of Touchplan. Proprietary Information Touchplan and Affiliate shall each exercise due diligence to maintain in confidence and not disclose to any third party any proprietary information furnished by the other to it on a confidential basis and identified as such when furnished. Except in accordance with this Agreement, neither party shall use such information without permission of the party that furnished it. As used in this paragraph, “due diligence” means the same precaution and standard of care which that party uses to safeguard its own proprietary data, but in no event less than reasonable care. The provisions of this Section shall survive for three (3) years beyond the expiration, non-renewal or termination of this Agreement. This Agreement does not grant any license under any patents or other intellectual property rights owned or controlled by or licensed to Touchplan. Affiliate shall not have any right to manufacture Touchplan products. Warranty Disclaimers The warranty terms and conditions for the sale of products will be as specified in the Touchplan Standard Terms and Conditions of Sale (EULA). In no event shall Affiliate make any representation, guarantee or warranty concerning Touchplan or any Touchplan product or service except as expressly authorized in writing by Touchplan. EXCEPT AS SPECIFICALLY PROVIDED IN THE EULA, TOUCHPLAN MAKES NO OTHER REPRESENTATION OR WARRANTY OF ANY KIND AND HEREBY DISCLAIMS ALL OTHER WARRANTIES, WHETHER EXPRESS OR IMPLIED, ORAL OR WRITTEN, WITH RESPECT TO THE SUBJECT MATTER HEREOF, INCLUDING WITHOUT LIMITATION, ALL IMPLIED WARRANTIES OF MERCHANTABILITY, FITNESS FOR ANY PARTICULAR PURPOSE, TITLE, NON-INFRINGEMENT, AND ALL WARRANTIES ARISING OUT OF ANY COURSE OF DEALING, COURSE OF PERFORMANCE OR USAGE IN TRADE. Limitation of Liability UNDER NO CIRCUMSTANCES, INCLUDING ANY INFRINGEMENT CLAIMS, SHALL TOUCHPLAN BE LIABLE TO AFFILIATE OR ANY OTHER PARTY FOR (I) ANY RE-PROCUREMENT COSTS, LOST REVENUE OR PROFITS OR FOR ANY OTHER SPECIAL, INCIDENTAL OR CONSEQUENTIAL DAMAGES, OR (II) ANY AGGREGATE DAMAGES IN EXCESS OF ONE THOUSAND DOLLARS, EVEN IF TOUCHPLAN HAS BEEN INFORMED OF SUCH POTENTIAL LOSS OR DAMAGE. Affiliate Fees Subject to the restrictions herein, Touchplan agrees to pay Affiliate the applicable percentage (the “Fee”) for all License Fees actually received from each Customer during the first twelve (12) months following execution by Customer of a valid EULA. Unless otherwise agreed in writing, the Fee shall be 10% of License Fees actually collected from the applicable Customer in the first 12-months of the EULA. Touchplan may also provide additional incentives or commissions as part of promotions (details contained within the promotion). Affiliate may choose to pass the Fee onto their referred client as a price discount for the first year of service. For the purposes of calculating the Fee, the following terms shall apply: “Customer” means a third party referred by Affiliate to Touchplan in accordance with this Agreement that (a) is not already an existing customer or known prospect of Touchplan, and (b) enters into a valid EULA within 12-months of the referral by Affiliate. All referrals will expire after such 12 month period unless otherwise agreed in writing by Touchplan. “License Fees” means all license fees net of any sales, use, value added, and other taxes or governmental assessments or withholding, and less any amounts repaid or credited by reason of rejections, defects, or returns (to the extent such amounts are included in such fees). License Fees shall not include any non-license fees paid by Customers, including but not limited to training, consulting, implementation, hardware, maintenance, professional services, third-party software fees, or any pass-through expenses paid Affiliate may refer a prospect via the online referral form, or using the assigned Affiliate’s link code—where a cookie will automatically track the referral and provide credit. Unless otherwise indicated, the cookie will be valid for 30 days, and must be used in the same browser from the link to retain cookie. Affiliate Fees are typically processed and paid within 30 days of the customer payment. Affiliate News By completing and submitting the Affiliate application, Affiliate agrees to receive emails from the Touchplan. These may contain important information about the affiliate program, existing or new products, and promotional ideas. Rejection of Affiliate Application Touchplan reserves the right to reject an Affiliate application for any reason. Compliance with Laws Affiliate agrees to comply with all laws and regulations that are applicable to the business that Affiliate transacts. Affiliate agrees to indemnify and hold Touchplan harmless for all liability or damages caused by Affiliate’s failure to comply with the terms of this provision. Jurisdiction This Agreement shall be governed by and construed in accordance with the laws of the Commonwealth of Massachusetts, without regard to its conflicts of law provisions. The sole venue for actions related to this Agreement will be the courts located in Boston, Massachusetts, and both parties consent to the jurisdiction of such courts with respect to any such action. This Agreement is the entire agreement and may be amended only by the parties to it in a signed writing. All notices must be sent via certified mail, or by email (if the receiving party acknowledges receipt). This Agreement and the rights and obligations hereunder are personal to Affiliate, and may not be subcontracted, delegated, assigned or otherwise transferred, in whole or in part, by Affiliate, without Touchplan’s prior written consent. Any attempt to do otherwise shall be void and of no effect. By submitting the Affiliate application, you acknowledge that you have read the foregoing terms and conditions, and that you understand and agree with them. By submitting this form, I agree to the terms of the referral partner agreement.CAPTCHAPhoneThis field is for validation purposes and should be left unchanged.