*Name of Business:

*Contact Name:

 Contact Title:

*Business Address:

*City:

*State:

*Zip:

*Phone:

 Fax:

 Website:

*E-mail Address:

 Questions:

Discount offered to Co-op Connections cardholders:

Exclusions:

By submitting this Contract I agree to be a participating Co-op Connections business and will give discounts to all Co-op Connections Cardholders. I can provide whatever discount I want, as long as it is something that provides a real economic value to Cardholders. I have chosen the discount described above. I will continue to offer this discount (or a better discount) for one year, unless Touchstone Energy or my local cooperative terminates this Contract. This Contract is effective from Mar 11, 2010, and it is self-renewing at the end of 12 months for an additional 24 months unless you notify us.

After we receive your signed contract, we will mail you window and cash register stickers to display in your business helping to identify you as a participating business.

ADDITIONAL TERMS AND CONDITIONS. Neither Touchstone Energy Cooperative, Inc. ("Touchstone Energy") nor any Touchstone Energy Cooperative ("Co-op") is liable for financial or contractual responsibilities of holders of the Co-op Connections Card ("Card"). Neither Touchstone Energy nor any Co-op will be liable for your products or services or for any inaccuracy in your marketing materials. All Cards are the property of Touchstone Energy, and any unauthorized reproduction or misrepresentation of the Card is strictly prohibited. Your marketing materials and advertisements will not use the name, trademark, or other intellectual property of Touchstone Energy or any Co-op without prior written approval. You will post Coop Connections signage as required by Touchstone Energy. Touchstone Energy or Co-op can terminate this Contract on 30 days notice (or immediately of you commit any material breach, if your business is sold or changes ownership, if your local participating cooperative drops out of the Touchstone Energy Cooperatives program, or if you become the subject of any bankruptcy or insolvency proceeding). You, your employees, and your affiliates will maintain the confidentiality of any confidential information belonging to Touchstone Energy or Co-op and that you will not disclose it to any third party. You agree to indemnify, defend and hold Touchstone Energy, Co-op and their affiliates and all of their employees, officers, directors and shareholders harmless against any and all losses, liabilities, damages, costs or other expenses or claims or counter claims of third persons or entities related to this Contract, except for any such claims arising from Touchstone Energy's or Co-op's gross negligence or willful misconduct. Each party waives its right to jury trial for any dispute relating to this Contract. Additional terms can be found at http://www.advancingthebrand.coop, and those terms control even if they conflict with this writing. Touchstone Energy can change any term of this Contract at any time by posting the change on any public section of this Web site dealing with the Co-op Connections program. Changes will be effective 30 days after posting.