Form of Subscription Agreement for Primary Offering
EXHIBIT 10.3
QUALIS INNOVATIONS, INC.
SUBSCRIPTION AGREEMENT
Qualis Innovations, Inc.
225 Wilmington West Chester Pike
Suite 200 # 145
Chadds Ford, Pennsylvania 19317
RE: Qualis Innovations, Inc. Common Stock
Ladies and Gentlemen:
The undersigned investor in this Subscription Agreement hereby acknowledges receipt of the Prospectus, dated __________________, 2021, of Qualis Innovations, Inc., a Nevada corporation (the “Company”), and subscribes for the following number of shares upon the terms and conditions set forth in the Prospectus.
The Investor agrees that this Subscription Agreement is subject to availability and acceptance by the Company.
The Investor hereby subscribes for ____________ shares of the Company’s common stock (“Common Stock”) at $_____ per share, for an aggregate purchase price of $____________.
Payment of $____________ as payment in full of the purchase price is being made via check directly to the Company.
If this subscription is rejected by the Company, in whole or in part, for any reason, all funds will be returned within three business days of the Company’s receipt of such funds, without interest or deduction of any kind.
Purchaser Information:
Printed Name: |
Signature: | ||
Date: | ||
Address: | ||
The foregoing Subscription is hereby accepted in full on behalf of Qualis Innovations, Inc.
Date: ___________________
QUALIS INNOVATIONS, INC. | ||
By: | ||
Name: | John Ballard | |
Title: | Chief Financial Officer |