EX-4.1
from SB-1
1 page
<page> Subscription Form To: Alya International, Inc. the Undersigned Hereby Acknowledges Receipt of the Prospectus, Dated , 1999, of Alya International, Inc. (The "Company") and Subscribes for the Following Number of Shares of the Company Upon the Terms and Conditions Set Forth Therein: Number of Shares: All Subscriptions Are Subject to Price Per Share: $ Acceptance by the Company, to Payment Enclosed: $ Availability, and to Certain Other Conditions, and Any Subscription May (Make Checks Payable to "Alya Be Declined in Whole or in Part by International, Inc." Return of the Subscription Monies Without Interest. Date: , 1999 Accepted by Company: Authorized Officer (Signature(s) of Subcriber(s) for Shares Social Security or Tax I.D. the Certificates for Such Stock Are Check One if More Than One Owner: To Be Issued as Follows: / / Joint Tenants Wrs / / Tenants in Common Name(s) / / Custodian Under Ugma Address Other
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