EX-4 5 0005.txt EX. 4.1 FORM OF SUBSCRIPTION AGREEMENT SUBSCRIPTION FORM To: COLUMBIA RIVER RESOURCES INC. The undersigned hereby acknowledges receipt of the Prospectus, dated ___________, 2000, of Columbia River Resources 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 ------------- acceptance by the Company, to Price Per Share: $ availability, and to certain other ------------- conditions, and any subscription may Payment Enclosed: $ be declined in whole or in part by ------------- return of the subscription monies without interest. (Make checks payable to "Columbia River Resources Inc.") Accepted by Company: Date:_________________, 2000 ------------------------------------ Authorized officer ----------------------------------- for Shares ----------------------------------- ---------------- (Signature(s) of Subcriber(s) ----------------------------------- Social Security or Tax I.D. Check one if more than one owner: The certificates for such stock are [ ] Joint tenants WRS to be issued as follows: [ ] Tenants in Common ----------------------------------- [ ] Custodian under UGMA Name(s) Other: ----------------------------------- -------------------------- ----------------------------------- Address ----------------------------------- -----------------------------------