Attached files

file filename
S-1 - APME S-1 04/24/15 - APPOINTMED, INC.apmes1_042415apg.htm
EX-3.2 - EXHIBIT 3.2 - APPOINTMED, INC.ex3_2apg.htm
EX-3.1 - EXHIBIT 3.1 - APPOINTMED, INC.ex3_1apg.htm
EX-5.1 - EXHIBIT 5.1 - APPOINTMED, INC.ex5_1apg.htm
EX-23.1 - EXHIBIT 23.1 - APPOINTMED, INC.ex23_1apg.htm


EXHIBIT 10.1




APPOINTMED, INC.

 SUBSCRIPTION AGREEMENT

The Investor named below, by payment of the purchase price for such Common Shares, by the delivery of a check payable to APPOINTMED, INC., hereby subscribes for the purchase of the number of Common Shares indicated below of APPOINTMED, INC., at a purchase of $0.01 per Share as set forth in the Prospectus.


By such payment, the named Investor further acknowledges receipt of the Prospectus and the Subscription Agreement, the terms of which govern the investment in the Common Shares being subscribed for hereby.


A. INVESTMENT:               (1) Number of Shares ___________________________



(2) Date of Investor's check _______________________


B. REGISTRATION:


(3) Registered owner: __________________________


Co-Owner: __________________________________


(4) Mailing address: ___________________________


City, State & zip: _________________________


(5) Residence Address (if different from above):


_________________________________


(6) Birth Date: ______/______/______


(7) Employee or Affiliate: Yes ______ No ______


(8) Social Security: #: ______/______/______


U.S. Citizen [  ] Other [  ] __________________________


Co-Owner Social Security:


#: ______/______/______


U.S. Citizen [ ] Other [ ]


Corporate or Custodial:


Taxpayer ID #: ______/______/______


U.S. Citizen [  ] Other [  ] ___________________________


(9) Telephone (H) ( ) ______________________


(10) *email address:__________________________




*Please note that by providing your email address, you accept that all further communications between you and the Company shall be by email, unless otherwise required by law and/or the rules and regulations of any governing body of traded securities.


 C. OWNERSHIP


[ ] Individual Ownership                                           [ ] IRA or Keogh


[ ] Joint Tenants with Rights of Survivorship


[ ] Trust/Date Trust Established_______________


[ ] Pension/Trust (S.E.P.)


[ ] Tenants in Common                                             [ ] Tenants by the Entirety


[ ] Corporate Ownership                                           [ ] Partnership


[ ] Other_____________________


D. SIGNATURES


Registered Owner: _____________________________



Co-Owner: _____________________________



Print Name of Custodian or Trustee: _____________________________



Authorized Signature: _____________________________



Date: _____________________



Signature: ___________________________________




MAIL TO:                          AppointMed, Inc.

2248 Meridian Blvd, Ste. H

Minden, Nevada 89423



____________________________________________________________________

FOR APPOINTMED, INC., OFFICE USE ONLY:


Date Received: ________________________________________________


Date Accepted/Rejected ________________________________________


Subscriber's Check Amount: _______________________


Check No. ___________________ Date Check ________________