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Survey Agreement

AGREEMENT FOR CONDUCTING AND PUBLISHING SURVEYS

---------------------, referred to as EMPLOYER, and -----------------------, referred to as SURVEY COMPANY, agree:

EMPLOYER retains SURVEY COMPANY to conduct a scientific survey of the following issues:

within the following territory:

and the following demographics:

Said survey shall take place over a time period beginning on __________, 20___ and concluding on_____________, 20___.

The survey shall be conducted by mail, with a sample size of approximately __________. The final report of the survey shall be issued on or about______________, 20___, and shall have a confidence interval of percent.

EMPLOYER shall have the exclusive right to broadcast, publish and utilize the survey results worldwide for a period of days.

EMPLOYER shall attribute the research results to the SURVEY COMPANY.

SURVEY COMPANY shall receive a fee of $ ( & no/100 dollars) to be paid .

Dated: _________________

__________________________

EMPLOYER

__________________________

SURVEY COMPANY