Exhibit 10.12 Form of Subscription Agreement ESSENTIAL INNOVATIONS TECHNOLOGY CORP. STOCK SUBSCRIPTION The undersigned hereby subscribes for the purchase of Essential Innovations Technology Corporation (the "Company") Common Stock as follows: Subscriber: Name: _____________________________________ Address: __________________________________ ___________________________________________ ___________________________________________ SS or Tax ID No.: _________________________ Number of shares purchased _____________________ Price per share _____________________ Total purchase price $____________________ The total purchase price shall be paid on or before ____________, 2003. PURCHASER: ------------------------ (Signature) The foregoing subscription shall be void if payment in good funds is not received on or before the close of business on the date specified above. Within five business days after receipt of funds for the above purchase (either on the collection of checks or the receipt of a wire transfer), the Company shall deliver to the above subscriber at the address stated certificates for the shares purchased. DATED: __________________, 2003. ESSENTIAL INNOVATIONS TECHNOLOGY CORP. By: --------------------------- Jason McDiarmid, President NOTE: Funds transferred by wire should be transmitted according to instructions provided by the Company under separate cover.