Terms: Features may in no way be changed in content. Biographical/contact information provided with each feature is expected to run intact, as provided. One 2-Month Trial per company/holding company. Trial includes all features available at time of order; features made available after time of order not included in trial. Trial period is two consecutive months and may not be paused or banked. Features offered by WFS, including those provided to you during this trial period, and any regular subscriptions during or after the trial period, are provided to you for the number of publications under the terms of your order, and may not be shared or borrowed by other newspapers, periodicals or channels within your company, media group, other sister periodicals or formats, or any outside media, except as provided by the terms of your agreement with WFS. Violation of any of these terms may be grounds for cancellation of this syndication order. You are always welcome to change or cancel your order, we only ask that you allow for a 30-day notice when possible.

Features you receive in trial: Note: Your trial period will end automatically. You must notify us which, if any, features you would like to continue with after the trial period.	• 50+ Wellness Quiz • Working Past Retirement • Life Story Workshop • Gray Matters
* Publication Name:
* Circulation:	- Select - Less than 10,000 10,000—25,000 25,000—50,000 50,000—100,000 100,000—250,000 250,000—500,000 Greater than 500,000
* Submitted By:
* Email:
Contact Person:
Contact Person Email:
* Phone Number:
Fax Number:
* Delivery Method: (How the quiz will be furnished to you each month)	Download Email Fax U.S. Mail
* This Order Will Be For:    (Must choose one)	Single Publication Multiple Publications – Delivered to a Single Address: (Must provide each publication's name and circulation in the 'Misc Instructions' box below) Multiple Publications – Delivered to Multiple Addresses: (Please provide publication name, circulation, and contact name, along with a mailing address / fax number / or email address for each delivery destination in the 'Multiple Delivery Addresses' box below, or submit under separate cover)
* Delivery Address: (Single Publication)~ Base this on your answer for 'Delivery Method' above: can be an Email address, Fax number, or U.S. Mail address
Multiple Delivery Addresses: Necessary only if delivery of column will be made to multiple addresses
* Payment Schedule:	Monthly Invoice / Net 30 3-Month Prepayment: 5% Discount 6-Month Prepayment: 10% Discount One-Year Prepayment: 15% Discount
* Billing Information: Please provide appropriate billing address information here
Misc Instructions:
Would you like immediate contact from us regarding this order?	Yes. No, just the standard response regarding my order.
	NOTE: You will always have the option to change the details of this (or any) order, or to cancel service with a 30-day notice.