Order Form- Custom Messages Please fill out the form to place your order. "*" indicates required fields Type of email*HTML emails can include color, layout and images. Plaintext emails are only text. HTML ($0.02 / email) Plaintext ($0.00 / email) Number of sends*The first send is included in the $100 one-time fee. There's a $50 one-time fee per additional send.Please enter a number from 1 to 3.Target send date*Please allow at least 2 days for email creation.Month123456789101112Day12345678910111213141516171819202122232425262728293031Year20232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Second target send date*Please allow at least 2 days for email creation.Month123456789101112Day12345678910111213141516171819202122232425262728293031Year20232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Third target send date*Please allow at least 2 days for email creation.Month123456789101112Day12345678910111213141516171819202122232425262728293031Year20232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Target audience details*Please enter any demographic or exclusion information for these messages. Our standard exclusions remove members marked deceased, opted out of CU or third-party contact, have written off, charged off, or delinquent loans, and invalid email addresses. All members 18+, standard exclusions All members 18+, no exclusions (ignores unsubscribes, etc. Often selected for transactional/breach/policy changes, etc) Other Email subject line* Message copy / text*Please write or paste the message here. Do not paste HTML into this field. If you have custom HTML, please write "HTML" here and upload a txt or Word file containing your HTML to the Other Files field below.Required disclosures*Compliance logos*Please select all compliance logos needed in this message. NCUA EHL EHO ASI Other (upload) None Upload other compliance logo*Please upload any compliance logos not available above. Drop files here or Select files Accepted file types: jpg, png, pdf, Max. file size: 2 MB. Other filesUpload any other files for this message, such as documents containing HTML, images, graphics, etc. Drop files here or Select files Max. file size: 2 MB. NotesAny details not covered above. Credit Union name*The full name of your Credit Union. CEO*The name of your Credit Union's CEO. First Last Contact name*The name of our contact for this project. First Last Contact phone number*The phone number of our contact for this project.Contact email*The email address of our contact for this project. Brand MaterialsPlease upload logos or brand materials. If Xtend Communications already has these materials, feel free to skip this section. Drop files here or Select files Max. file size: 2 MB. Terms & conditions*Xtend shall not be held responsible for errors or omissions within this form or upon delivery including but not limited to, dates, text, target member groups and delivery method. You (“the Credit Union”) will be sent one test message to an email address of your choosing. You will be given one opportunity to revise the message text at this point. You are responsible for providing approval or revisions of the test message in a timely manner. Xtend reserves the right to delay your send date as needed if we do not receive approval of the test message within 1 business day prior to the send date. I agree to the terms and conditions.Pricing specifics*Please note that there will be a $100 charge for data mining, message creation, and processing, along with a $00.02 per email cost for HTML emails. If you have or are requesting a custom pricing agreement, please check the "other" option and explain. I accept the $100 fee (plus $00.02 per email if HTML) for this message. Other HTML Indemnification*Xtend E-Communication HTML Indemnification Agreement Compliance: It is the intent of XTEND to comply with all known U.S. federal, state and local laws and regulations applicable to the services to be performed by XTEND. XTEND does not warrant that all services provided shall comply with all known U.S. federal, state, and local laws and regulations applicable to the Services to be provided by XTEND. Confirming compliance with all known U.S. federal, state and local laws and regulations applicable to the Services to be performed by XTEND set forth in this Master Services Agreement shall be your CREDIT UNION’s non-delegable responsibility. Our Responsibility: XTEND’s sole responsibility is to exercise slight care in processing your campaign in accordance with this Agreement. All campaigns will be processed in accordance with the instructions provided by your CREDIT UNION with this Service and in accordance with the terms of this Agreement. Indemnity: Your CREDIT UNION assumes the risk of and shall indemnify XTEND, its directors, officers, employees and agents and shall hold them harmless from and against any actions, suits, damages, judgments, costs, charges, expenses, attorney fees, and consequences of any liability, of any nature (“Losses”), incurred, made or suffered by any third party in connection with the furnishing of services by XTEND under this Agreement, except for Losses due to gross negligence, or the fraud or intentional, willful, and wanton act of XTEND. Exclusive Remedy: Your CREDIT UNION agrees that the liability of XTEND and its directors, officers, employees, and agents with regard to the services provided by this Agreement for any actions, suits, damages, judgments, costs, charges, expenses, and attorney fees (“the Losses”) for which they are or may be legally liable, whether arising in negligence or other tort, contract or otherwise shall not exceed in the aggregate the costs of correction of the error, omission or other problem which is the basis for the Losses, except in regards to matters resulting due to the gross negligence or intentional acts of XTEND. Governmental Inspection: Member records maintained by XTEND shall be at all times and without prior written notice to your CREDIT UNION be available for examination and audit by appropriate federal and state agencies, as permitted by law. By entering into this Agreement, XTEND agrees that the State of Michigan Department of Insurance and Financial Services (“DIFS”), the National Credit Union Administration (“NCUA”), or any other regulatory agencies having authority over the CREDIT UNION’s operations shall have the authority and responsibility provided to the regulatory agencies pursuant to statute, regulation or rule, including but not limited to Michigan Credit Union Act, Subsection 408(4). I have read, understand, and agree to the Xtend E-Communication HTML Indemnification Agreement. I have also reviewed this form and my answers, and give approval on behalf of my credit union for Xtend to process this request.