Document:

Anavex Life Sciences Corp.: Exhibit 10.2 - Filed by newsfilecorp.com

(U.S. ACCREDITED SUBSCRIBERS ONLY)

NONE OF THE SECURITIES TO WHICH THIS PRIVATE PLACEMENT
SUBSCRIPTION AGREEMENT (THE “SUBSCRIPTION AGREEMENT”) RELATES HAVE BEEN
REGISTERED UNDER THE UNITED STATES SECURITIES ACT OF 1933, AS AMENDED (THE “1933
ACT”), OR ANY U.S. STATE SECURITIES LAWS, AND, UNLESS SO REGISTERED, NONE MAY BE
OFFERED OR SOLD IN THE UNITED STATES OR TO U.S. PERSONS (AS DEFINED HEREIN)
EXCEPT PURSUANT TO AN EXEMPTION FROM, OR IN A TRANSACTION NOT SUBJECT TO, THE
REGISTRATION REQUIREMENTS OF THE 1933 ACT AND IN EACH CASE ONLY IN ACCORDANCE
WITH APPLICABLE STATE SECURITIES LAWS.

ANAVEX LIFE SCIENCES CORP.

PRIVATE PLACEMENT SUBSCRIPTION AGREEMENT UNITS

INSTRUCTIONS TO PURCHASER

	1. 	
      This Subscription form is for use by United States
      Accredited Investors.

	 	 
	2. 	
      COMPLETE the information on page 2 of this
      Subscription Agreement.

	 	 
	3. 	
      COMPLETE the Questionnaire attached on page 5 to
      this Subscription Agreement (the “Questionnaire”).

	 	 
	4. 	
      Check or Cashier’s check should be made payable to
      Anavex Life Sciences Corp. For Wire instructions contact Harvey Lalach,
      CFO of Anavex harvey@anavex.com Tel (250) 764-9701.

	 	 
	5. 	
      All other information must be filled in where
      appropriate.

Wire Instructions:

HSBC BANK CANADA
885 WEST GEORGIA
STREET 
VANCOUVER, BRITISH COLUMBIA 
V6C 3G1 CANADA
ACCOUNT: ANAVEX
LIFE SCIENCES CORP. 
SWIFT CODE: HKBCCATT
ACCOUNT NO: 020-894066-071

This is Page 2 of 12 pages of a subscription agreement and
related appendices, schedules and forms. Collectively, these pages together are
referred to as the “Subscription Agreement”.

PRIVATE PLACEMENT SUBSCRIPTION AGREEMENT

TO: ANAVEX LIFE SCIENCES CORP. (the “Issuer”), of 2,
Place du Port, Geneva, Switzerland Ch-1204. 

Subject and pursuant to the terms set out in the Terms on pages
3 to 4, the General Provisions on pages 7 to 12 and the other schedules and
appendices attached which are hereby incorporated by reference, the Purchaser
hereby irrevocably subscribes for, and on Closing will purchase from the Issuer,
the following securities at the following price:

	___________Units 
	US$2.50 per Unit for a total purchase price of US$ 	 
	 
	The Purchaser owns, directly or
      indirectly, the following securities of the Issuer: 
	 
	  
	[Check if applicable] The
      Purchaser is   [   ]   an insider of the
      Issuer or    [   ]    a member of
      the professional group 

The Purchaser directs the Issuer to issue, register and deliver
the certificates representing the Units as follows:

	           
               REGISTRATION INSTRUCTIONS 	 	       
                       
       DELIVERY INSTRUCTIONS 
	 	 	 
	Name to appear on certificate 	 	Name and account reference, if applicable 
	 	 	 
	Account reference if applicable 	 	Contact name 
	 	 	 
	Address 	 	Address 
	 	 	 
	  	 	Telephone Number 
	 	 	 

EXECUTED by the Purchaser this _______day of
_____________the Purchaser and any beneficial purchaser for whom the Purchaser
is acting is resident in the jurisdiction shown as the “Address of Purchaser”.

	WITNESS: 	 	       
                       EXECUTION
      BY PURCHASER: 
	 	 	 
	   	 	X 
	Signature of Witness 	 	Signature of individual (if Purchaser is an individual)
    
	 	 	 
	          	 	X 
	Name of Witness 	 	Authorized signatory (if Purchaser is not an
      individual) 
	 	 	 
	     	 	  
	Address of Witness 	 	Name of Purchaser (please print) 
	 	 	  
	 	 	Name of authorized signatory (please print) 
	Accepted this day of ____________, 2010 	 	  
	ANAVEX LIFE SCIENCES CORP. 	 	Address of Purchaser (residence) 
	Per: 	 	  
	 	 	Telephone Number 
	Authorized Signatory 	 	  
	 	 	E-mail address 
	 	 	  
	 	 	Social Security No.:
  

By signing this acceptance, the Issuer agrees to be bound by
the Terms on pages 3 to 4, the General Provisions on pages 7 to 12 and the other
schedules and appendices incorporated by reference. If funds are delivered to
the Issuer’s lawyers, they are authorized to release the funds to the Issuer.

	Subscription Agreement (with related appendices,
      schedules and forms) 	Page 3 of 12 

TERMS

	Reference date of this Subscription 	  	  
	Agreement 	May 14, 2010 (the “Agreement
      Date”). 
	 	 
	  The Offering 
	  	  	  
	  	  	  
	The Issuer 	Anavex Life Sciences Corp. (the
      “Issuer”). 
	  	  	  
	Offering 	The offering consists of Units
      (“Units”) of the Issuer. Each Unit consists of one share of Common
      Stock and one half of one Warrant (each Unit comprises half the number of
      Warrants as Shares). 
	  	  	  
	Common Stock 	The voting shares of Common Stock of
      the Issuer (“Shares”). 
	  	  	  
	Warrants 	Each whole Warrant may be exercised
      for18 months following the Closing Date for one share of Common Stock (a
      “Warrant Share”) at an exercise price of $3.50. The Warrants are
      non-transferrable. 
	  	  	  
	Issue Price 	US$2.50 per Unit. 
	  	  	  
	Total Amount 	No minimum to a maximum of $3.5
      million. 
	  	  	  
	Selling Jurisdictions 	The Units may be sold in
      jurisdictions where they may be lawfully sold (the ”Selling
      Jurisdictions”). 
	  	  	  
	Exemptions 	The offering will be made in
      accordance with the following exemptions: 
	  	  	  
		(a) 	the Accredited Investor exemption as defined by
      Regulation D promulgated under the 1933 Act; and 
	  	  	  
	  	(b) 	   such other exemptions as may be
      available the securities laws of the   Selling
      Jurisdictions. 
	  	  	  
	Registration of Securities 	The Shares and Warrants will not be
      registered with the United States Securities and Exchange Commission and
      will be tradable in compliance  with Rule 144 restricted
      periods. 
	  	  	  
	Resale restrictions and legends 	The Purchaser acknowledges that the
      certificates representing the Securities will bear the following legends:
    
	  	  	  
			“NONE OF THE SECURITIES TO WHICH THIS PRIVATE
      PLACEMENT SUBSCRIPTION AGREEMENT (THE “SUBSCRIPTION AGREEMENT”) RELATES
      HAVE BEEN REGISTERED UNDER THE UNITED STATES SECURITIES ACT OF 1933, AS
      AMENDED (THE “1933 ACT”), OR ANY U.S. STATE SECURITIES LAWS, AND, UNLESS
      SO REGISTERED, NONE MAY BE OFFERED OR SOLD IN THE UNITED STATES OR TO U.S.
      PERSONS (AS DEFINED HEREIN) EXCEPT PURSUANT TO AN EXEMPTION FROM, OR IN A
      TRANSACTION NOT SUBJECT TO, THE REGISTRATION REQUIREMENTS OF THE 1933 ACT
      AND IN EACH CASE ONLY IN ACCORDANCE WITH APPLICABLE
      STATE   SECURITIES LAWS.” 
	  	  	  
	  	Purchasers are advised to consult
      with their own legal counsel or advisors 
	  	to determine the resale restrictions
      that may be applicable to them. 

Subscription Agreement (with related appendices, schedules
and forms) Page 4 of 12

	Closing Date 	The completion of the sale and
      purchase of the Units will take place in one or more closings, on a date
      or dates as agreed to by the Issuer and the Purchaser. Payment for, and
      delivery of the Securities, is scheduled to occur on or about June 14,
      2010 or such later date as may be agreed upon by the Issuer and the
      Purchaser (the “Closing Date”). 
	 	 
	Use of Proceeds (Approx. Numbers
      
based on raise of $3.5 million) 	Phase 1 Clinical Trial – Anavex 2-73
      $1.3 million 
	 
	Phase 2a Clinical Trial – Anavex 2-73
      $500,000 
	 	 
	  	 (To be conducted simultaneously
      with phase 1 to test for efficacy) 
	 	 
	  	Forenap France (CRO) 	  
	 	 	 
		Research collaboration – Dr Mark
      Smith, Case Case Western University Cleveland, Ohio $100,000 
	 	 
		Research collaboration –Dr Tangui
      Maurice,Universite Montpellier/ Amylgen SA France $100,000 
	 	 
		Research collaboration – O. Soriani
      Universite Nice Sophia Antipolis France $40,000 
	 	 
	  	Research and development $360,000
  
	 	 
	  	Working Capital - $1,100,000 
	 	 
	 The Issuer  
	 
	Jurisdiction of organization 	The Issuer is incorporated under the
      laws of the State of Nevada. 
	 	 
	Stock exchange listing 	OTC-BB 
	 	 
	Commissions with Jurisdiction Over the Issuer
    	The “Commissions with Jurisdiction
      Over the Issuer” is the United States Securities and Exchange
      Commission. 
	 	 
	Securities Legislation Applicable to the
      Issuer 	The “Securities Legislation
      Applicable to the Issuer” is the US Securities Exchange Act of 1934.
    
	  	 
	 End of Terms

	Subscription Agreement (with related appendices,
      schedules and forms) 	Page 5 of 12 

UNITED STATES
ACCREDITED INVESTOR
QUESTIONNAIRE

All capitalized terms herein, unless otherwise defined, have
the meanings ascribed thereto in the Subscription Agreement.

This Questionnaire is for use by each Subscriber who is a US
person (as that term is defined Regulation S of the United States Securities Act
of 1933 (the “1933 Act”)) and has indicated an interest in purchasing Securities
of the Issuer. The purpose of this Questionnaire is to assure the Issuer that
each Subscriber will meet the standards imposed by the 1933 Act and the
appropriate exemptions of applicable state securities laws. The Issuer will rely
on the information contained in this Questionnaire for the purposes of such
determination. The Securities will not be registered under the 1933 Act in
reliance upon the exemption from registration afforded by Section 3(b) and/or
Section 4(2) and Regulation D of the 1933 Act. This Questionnaire is not an
offer of the Securities or any other securities of the Issuer in any state other
than those specifically authorized by the Issuer.

All information contained in this Questionnaire will be treated
as confidential. However, by signing and returning this Questionnaire, each
Subscriber agrees that, if necessary, this Questionnaire may be presented to
such parties as the Issuer deems appropriate to establish the availability,
under the 1933 Act or applicable state securities law, of exemption from
registration in connection with the sale of the Securities hereunder.

The Subscriber covenants, represents and warrants to the Issuer
that it satisfies one or more of the categories of “Accredited Investors”, as
defined by Regulation D promulgated under the 1933 Act, as indicated below:
(Please initial in the space provide those categories, if any, of an “Accredited
Investor” which the Subscriber satisfies.)

	_______ Category 1 	
      An organization described in Section 501(c)(3) of the
      United States Internal Revenue Code, a corporation, a Massachusetts or
      similar business trust or partnership, not formed for the specific purpose
      of acquiring the Securities, with total assets in excess of US $5,000,000.
      

	  	  
	_______ Category 2 	
      A natural person whose individual net worth, or joint net
      worth with that person’s spouse, on the date of purchase exceeds US
      $1,000,000. 

	  	
       

	_______ Category 3 	
      A natural person who had an individual income in excess
      of US $200,000 in each of the two most recent years or joint income with
      that person’s spouse in excess of US $300,000 in each of those years and
      has a reasonable expectation of reaching the same income level in the
      current year. 

	  	  
	_______ Category 4 	
      A “bank” as defined under Section (3)(a)(2) of the 1933
      Act or savings and loan association or other institution as defined in
      Section 3(a)(5)(A) of the 1933 Act acting in its individual or fiduciary
      capacity; a broker dealer registered pursuant to Section 15 of the
      Securities Exchange Act of 1934 (United States); an insurance
      company as defined in Section 2(13) of the 1933 Act; an investment company
      registered under the Investment Company Act of 1940 (United
      States) or a business development company as defined in Section 2(a)(48)
      of such Act; a Small Business Investment Company licensed by the U.S.
      Small Business Administration under Section 301(c) or (d) of the Small
      Business Investment Act of 1958 (United States); a plan with
      total assets in excess of $5,000,000 established and maintained by a
      state, a political subdivision thereof, or an agency or instrumentality of
      a state or a political subdivision thereof, for the benefit of its
      employees; an employee benefit plan within the meaning of the Employee
      Retirement Income Security Act of 1974 (United States) whose
      investment decisions are made by a plan fiduciary, as defined in Section
      3(21) of such Act, which is either a bank, savings and loan association,
      insurance company or registered investment adviser, or if the employee
      benefit plan has total assets in excess of $5,000,000, or, if a
      self-directed plan, whose investment decisions are made solely by persons
      that are accredited investors. 

	  	  
	_______ Category 5 	A private business development company as
      defined in Section 202(a)(22) of the Investment Advisers Act of 1940
      (United States). 

	Subscription Agreement (with related appendices,
      schedules and forms) 	Page 6 of 12 

	_______   Category 6 	A director or executive officer of the Issuer.
    
	  	  
	_______ Category 7 	
      A trust with total assets in excess of $5,000,000, not
      formed for the specific purpose of acquiring the Securities, whose
      purchase is directed by a sophisticated person as described in Rule
      506(b)(2)(ii) under the 1933 Act. 

	  	  
	_______ Category 8 	An entity in which all of the equity owners
      satisfy the requirements of one or more of the foregoing categories.
  

Note that prospective Subscribers claiming to satisfy one of
the above categories of Accredited Investor may be required to supply the Issuer
with a balance sheet, prior years’ federal income tax returns or other
appropriate documentation to verify and substantiate the Subscriber’s status as
an Accredited Investor.

If the Subscriber is an entity which initialled Category 8 in
reliance upon the Accredited Investor categories above, state the name, address,
total personal income from all sources for the previous calendar year, and the
net worth (exclusive of home, home furnishings and personal automobiles) for
each equity owner of the said entity: 

		

The Subscriber hereby certifies that the information contained
in this Questionnaire is complete and accurate and the Subscriber will notify
the Issuer promptly of any change in any such information. If this Questionnaire
is being completed on behalf of a corporation, partnership, trust or estate, the
person executing on behalf of the Subscriber represents that it has the
authority to execute and deliver this Questionnaire on behalf of such
entity.

IN WITNESS WHEREOF, the undersigned has executed this
Questionnaire as of the ___ day of _______________, 2010.

	If a Corporation, Partnership or Other Entity: 	 	If an Individual: 
	  	 	  
	 	 	 
	Print of Type Name of Entity 	 	Signature 
	 	 	 
	 	 	 
	Signature of Authorized Signatory 	 	Print or Type Name 
	 	 	 
	 	 	 
	Type of Entity 	 	Social Security/Tax I.D. No.

	Subscription Agreement (with related appendices,
      schedules and forms) 	Page 7 of 12 

GENERAL PROVISIONS

1. DEFINITIONS

1.1 In the Subscription Agreement (including the first (cover)
page, the Terms on pages 3 to 4, the General Provisions on pages 7 to 12 and the
other schedules and appendices incorporated by reference), the following words
have the following meanings unless otherwise indicated:

	 	(a) 	
      “1933 Act” means the United States Securities Act
      of 1933, as amended;

	 	 	 
	 	(b) 	
      “Applicable Legislation” means the Securities
      Legislation Applicable to the Issuer (as defined on page 4) and all
      legislation incorporated in the definition of this term in other parts of
      the Subscription Agreement, together with the regulations and rules made
      and promulgated under that legislation and all administrative policy
      statements, blanket orders and rulings, notices and other administrative
      directions issued by the Commissions;

	 	 	 
	 	(c) 	
      “Closing” means the completion of the sale and
      purchase of the Securities;

	 	 	 
	 	(d) 	
      “Closing Date” has the meaning assigned in the
      Terms;

	 	 	 
	 	(e) 	
      “Commissions” means the Commissions with
      Jurisdiction over the Issuer (as defined on page 4) and the securities
      commissions incorporated in the definition of this term in other parts of
      the Subscription Agreement;

	 	 	 
	 	(f) 	
      “General Provisions” means those portions of the
      Subscription Agreement headed “General Provisions” and contained on
      pages 7 to 12;

	 	 	 
	 	(g) 	
      “Private Placement” means the offering of the
      Securities on the terms and conditions of this Subscription
    Agreement;

	 	 	 
	 	(h) 	
      “Securities” means the shares of Common Stock, the
      Warrants and the Warrant Shares, as defined in the Terms;

	 	 	 
	 	(i) 	
      “Subscription Agreement” means the first (cover)
      page, the Terms on pages 3 to 4, the General Provisions on pages 7 to 12
      and the other schedules and appendices incorporated by reference;
    and

	 	 	 
	 	(j) 	
      “Terms” means those portions of the Subscription
      Agreement headed “Terms” and contained on pages 3 to
4.

1.2 In the Subscription Agreement, the following terms have the
meanings defined in Regulation S of the 1933 Act (“Regulation S”): “Directed
Selling Efforts”, “Foreign Issuer”, “Substantial U.S. Market
Interest”, “U.S. Person” and “United States”.

1.3 In the Subscription Agreement, unless otherwise specified,
currencies are indicated in US dollars.

1.4 In the Subscription Agreement, other words and phrases that
are capitalized have the meanings assigned to them in the body hereof.

2. ACKNOWLEDGEMENTS, REPRESENTATIONS AND WARRANTIES OF
PURCHASER

2.1 Acknowledgements concerning Offering

The Purchaser acknowledges that:

	Subscription Agreement (with related appendices,
      schedules and forms) 	Page 8 of 12 

	 	(a) 	
      the Securities have not been registered under the 1933
      Act, or under any state securities or “blue sky” laws of any state of the
      United States, and are being offered only in a transaction not involving
      any public offering within the meaning of the 1933 Act, and, unless so
      registered, may not be offered or sold in the United States or to U.S.
      Persons, except pursuant to an effective registration statement under the
      1933 Act, or pursuant to an exemption from, or in a transaction not
      subject to, the registration requirements of the 1933 Act, and in each
      case only in accordance with Applicable Legislation;

	 	 	 
	 	(b) 	
      the Issuer will refuse to register any transfer of the
      Securities not made in accordance with the provisions of Regulation S,
      pursuant to an effective registration statement under the 1933 Act or
      pursuant to an available exemption from, or in a transaction not subject
      to, the registration requirements of the 1933 Act;

	 	 	 
	 	(c) 	
      the Issuer has not undertaken, and will have no
      obligation, to register any of the Securities under the 1933
Act;

	 	 	 
	 	(d) 	
      the decision to execute this Subscription Agreement and
      purchase the Securities agreed to be purchased hereunder has not been
      based upon any oral or written representation as to fact or otherwise made
      by or on behalf of the Issuer and such decision is based entirely upon a
      review of information (the “Issuer Information”) which has been provided
      by the Issuer to the Purchaser. If the Issuer has presented a business
      plan or any other type of corporate profile to the Purchaser, the
      Purchaser acknowledges that the business plan, the corporate profile and
      any projections or predictions contained in any such documents may not be
      achieved or be achievable;

	 	 	 
	 	(e) 	
      the Purchaser and the Purchaser’s advisor(s) have had a
      reasonable opportunity to ask questions of and receive answers from the
      Issuer regarding the Offering, and to obtain additional information, to
      the extent possessed or obtainable without unreasonable effort or expense,
      necessary to verify the accuracy of the information contained in the
      Issuer Information, or any business plan, corporate profile or any other
      document provided to the Purchaser;

	 	 	 
	 	(f) 	
      the books and records of the Issuer are available upon
      reasonable notice for inspection, subject to certain confidentiality
      restrictions, by the Purchaser during reasonable business hours at its
      principal place of business and that all documents, records and books
      pertaining to this Offering have been made available for inspection by the
      Purchaser, the Purchaser’s attorney and/or advisor(s);

	 	 	 
	 	(g) 	
      by execution hereof the Purchaser has waived the need for
      the Issuer to communicate its acceptance of the purchase of the Securities
      pursuant to this Subscription Agreement;

	 	 	 
	 	(h) 	
      the Issuer is entitled to rely on the representations and
      warranties and the statements and answers of the Purchaser contained in
      this Subscription Agreement and in the Questionnaire, and the Purchaser
      will hold harmless the Issuer from any loss or damage it may suffer as a
      result of the Purchaser’s failure to correctly complete this Subscription
      Agreement or the Questionnaire;

	 	 	 
	 	(i) 	
      the Purchaser will indemnify and hold harmless the Issuer
      and, where applicable, its respective directors, officers, employees,
      agents, advisors and shareholders from and against any and all loss,
      liability, claim, damage and expense whatsoever (including, but not
      limited to, any and all fees, costs and expenses whatsoever reasonably
      incurred in investigating, preparing or defending against any claim,
      lawsuit, administrative proceeding or investigation whether commenced or
      threatened) arising out of or based upon any representation or warranty of
      the Purchaser contained herein, the Questionnaire or in any other document
      furnished by the Purchaser to the Issuer in connection herewith, being
      untrue in any material respect or any breach or failure by the Purchaser
      to comply with any covenant or agreement made by the Purchaser to the
      Issuer in connection therewith;

	Subscription Agreement (with related appendices,
      schedules and forms) 	Page 9 of 12 

	 	(j) 	
      the issuance and sale of the Securities to the Purchaser
      will not be completed if it would be unlawful or if, in the discretion of
      the Issuer acting reasonably, it is not in the best interests of the
      Issuer;

	 	 	 
	 	(k) 	
      the Purchaser has been advised to consult its own legal,
      tax and other advisors with respect to the merits and risks of an
      investment in the Securities and with respect to applicable resale
      restrictions and it is solely responsible (and the Issuer is not in any
      way responsible) for compliance with applicable resale
  restrictions;

	 	 	 
	 	(l) 	
      the Securities are not listed on any stock exchange or
      automated dealer quotation system and no representation has been made to
      the Purchaser that any of the Securities will become listed on any stock
      exchange or automated dealer quotation system, except that currently
      certain market makers make market in shares of the Issuer on the National
      Association of Securities Dealers Inc.’s OTC Bulletin Board;

	 	 	 
	 	(m) 	
      neither the Commissions or similar regulatory authority
      has reviewed or passed on the merits of the Securities;

	 	 	 
	 	(n) 	
      no documents in connection with this Offering have been
      reviewed by the SEC or any state securities administrators;

	 	 	 
	 	(o) 	
      there is no government or other insurance covering any of
      the Securities;

	 	 	 
	 	(p) 	
      this Subscription Agreement is not enforceable by the
      Purchaser unless it has been accepted by the Issuer, and the Purchaser
      acknowledges and agrees that the Issuer reserves the right to reject any
      subscription for any reason; and

	 	 	 
	 	(q) 	
      by executing and delivering this Subscription Agreement,
      each Purchaser will have directed the Issuer not to include a Canadian
      legend on any certificates representing the Securities to be issued to
      such Purchaser. As a consequence, the Purchaser will not be able to rely
      on the resale provisions of National Instrument 45-102, as adopted by the
      securities commissions of Canada, and any subsequent trade in the
      Securities during or after the Canadian hold period described therein will
      be a distribution subject to the prospectus and registration requirements
      of Canadian securities legislation, to the extent that the trade is at
      that time subject to any such Canadian securities
  legislation.

2.2 Representations by the Purchaser

The Purchaser represents and warrants to the Issuer that, as at
the Agreement Date and at the Closing:

	 	(a) 	
      the Purchaser is resident in the United States;

	 	 	 
	 	(b) 	
      the Purchaser has received and carefully read this
      Subscription Agreement;

	 	 	 
	 	(c) 	
      the Purchaser has the legal capacity and competence to
      enter into and execute this Subscription Agreement and to take all actions
      required pursuant hereto and, if the Purchaser is a corporation, it is
      duly incorporated and validly subsisting under the laws of its
      jurisdiction of incorporation and all necessary approvals by its
      directors, shareholders and others have been obtained to authorize
      execution and performance of this Subscription Agreement on behalf of the
      Purchaser;

	 	 	 
	 	(d) 	
      the Purchaser (i) has adequate net worth and means of
      providing for its current financial needs and possible personal
      contingencies, (ii) has no need for liquidity in this investment, and
      (iii) is able to bear the economic risks of an investment in the
      Securities for an indefinite period of time, and can afford the complete
      loss of such investment;

	Subscription Agreement (with related appendices,
      schedules and forms) 	Page 10 of 12 

	 	(e) 	
      the Purchaser is aware that an investment in the Issuer
      is speculative and involves certain risks, including the possible loss of
      the investment;

	 	 	 
	 	(f) 	
      the entering into of this Subscription Agreement and the
      transactions contemplated hereby do not result in the violation of any of
      the terms and provisions of any law applicable to, or, if applicable, the
      constating documents of, the Purchaser, or of any agreement, written or
      oral, to which the Purchaser may be a party or by which the Purchaser is
      or may be bound;

	 	 	 
	 	(g) 	
      the Purchaser has duly executed and delivered this
      Subscription Agreement and it constitutes a valid and binding agreement of
      the Purchaser enforceable against the Purchaser;

	 	 	 
	 	(h) 	
      the Purchaser has the requisite knowledge and experience
      in financial and business matters as to be capable of evaluating the
      merits and risks of the investment in the Securities and the Issuer, and
      the Purchaser is providing evidence of such knowledge and experience in
      these matters through the information requested in the
    Questionnaire;

	 	 	 
	 	(i) 	
      the Purchaser understands and agrees that the Issuer and
      others will rely upon the truth and accuracy of the acknowledgements,
      representations and agreements contained in this Subscription Agreement,
      and agrees that if any of such acknowledgements, representations and
      agreements are no longer accurate or have been breached, the Purchaser
      shall promptly notify the Issuer;

	 	 	 
	 	(j) 	
      all information contained in the Questionnaire is
      complete and accurate and may be relied upon by the Issuer, and the
      Purchaser will notify the Issuer immediately of any material change in any
      such information occurring prior to the closing of the purchase of the
      Securities;

	 	 	 
	 	(k) 	
      the Purchaser is purchasing the Securities for its own
      account for investment purposes only and not for the account of any other
      person and not for distribution, assignment or resale to others, and no
      other person has a direct or indirect beneficial interest is such
      Securities, and the Purchaser has not subdivided his interest in the
      Securities with any other person;

	 	 	 
	 	(l) 	
      the Purchaser is not an underwriter of, or dealer in, the
      common shares of the Issuer, nor is the Purchaser participating, pursuant
      to a contractual agreement or otherwise, in the distribution of the
      Securities;

	 	 	 
	 	(m) 	
      the Purchaser understands and agrees that none of the
      Securities have been registered under the 1933 Act, or under any state
      securities or “blue sky” laws of any state of the United States, and,
      unless so registered, may not be offered or sold in the United States or,
      directly or indirectly, to U.S. Persons except in accordance with the
      provisions of Regulation S, pursuant to an effective registration
      statement under the 1933 Act, or pursuant to an exemption from, or in a
      transaction not subject to, the registration requirements of the 1933
      Act;

	 	 	 
	 	(n) 	
      the Purchaser understands and agrees that the Issuer will
      refuse to register any transfer of the Securities not made in accordance
      with the provisions of Regulation S, pursuant to an effective registration
      statement under the 1933Act or pursuant to an available exemption from the
      registration requirements of the 1933 Act;

	 	 	 
	 	(o) 	
      the Purchaser has made an independent examination and
      investigation of an investment in the Securities and the Issuer and has
      depended on the advice of its legal and financial advisors and agrees that
      the Issuer will not be responsible in any way whatsoever for the
      Purchaser’s decision to invest in the Securities of the Issuer;

	 	 	 
	 	(p) 	
      if the Purchaser is acquiring the Securities as a
      fiduciary or agent for one or more investor accounts, the investor
      accounts for which the Purchaser acts as a fiduciary or agent satisfy the
      definition of an “Accredited Investor”, as the term is defined under
      Regulation D of the 1933 Act;

	Subscription Agreement (with related appendices,
      schedules and forms) 	Page 11 of 12 

	 	(q) 	
      if the Purchaser is acquiring the Securities as a
      fiduciary or agent for one or more investor accounts, the Purchaser has
      sole investment discretion with respect to each such account, and the
      Purchaser has full power to make the foregoing acknowledgements,
      representations and agreements on behalf of such account;

	 	 	 	 
	 	(r) 	
      the Purchaser is not aware of any advertisement of any of
      the Securities and is not acquiring the Securities as a result of any form
      of general solicitation or general advertising including advertisements,
      articles, notices or other communications published in any newspaper,
      magazine or similar media or broadcast over radio or television, or any
      seminar or meeting whose attendees have been invited by general
      solicitation or general advertising; and

	 	 	 	 
	 	(s) 	
      no person has made to the Purchaser any written or oral
      representations:

	 	 	 	 
	 		(i) 	
      that any person will resell or repurchase any of the
      Securities;

	 	 	 	 
	 		(ii) 	
      that any person will refund the purchase price of any of
      the Securities;

	 	 	 	 
	 		(iii) 	
      as to the future price or value of any of the Securities;
      or

	 	 	 	 
	 		(iv) 	
      that any of the Securities will be listed and posted for
      trading on any stock exchange or automated dealer quotation system or that
      application has been made to list and post any of the Securities of the
      Issuer on any stock exchange or automated dealer quotation
  system.

2.3 Reliance, indemnity and notification of changes

The representations and warranties in the Subscription
Agreement (including the first (cover) page, the Terms on pages 3 to 4, the
General Provisions on pages 7 to 12 and the other schedules and appendices
incorporated by reference) are made by the Purchaser with the intent that they
be relied upon by the Issuer in determining its suitability as a purchaser of
Securities, and the Purchaser hereby agrees to indemnify the Issuer against all
losses, claims, costs, expenses and damages or liabilities which any of them may
suffer or incur as a result of reliance thereon. The Purchaser undertakes to
notify the Issuer immediately of any change in any representation, warranty or
other information relating to the Purchaser set forth in the Subscription
Agreement (including the first (cover) page, the Terms on pages 3 to 4, the
General Provisions on pages 7 to 12 and the other schedules and appendices
incorporated by reference) which takes place prior to the Closing.

2.4 Survival of representations and warranties

The representations and warranties contained in this Section
will survive the Closing.

3. ISSUER’S ACCEPTANCE

The Subscription Agreement, when executed by the Purchaser, and
delivered to the Issuer, will constitute a subscription for Securities which
will not be binding on the Issuer until accepted by the Issuer by executing the
Subscription Agreement in the space provided on the face page(s) of the
Subscription Agreement and, notwithstanding the Agreement Date, if the Issuer
accepts the subscription by the Purchaser, the Subscription Agreement will be
entered into on the date of such execution by the Issuer.

4. CLOSING

4.1 On or before the end of the business day before the Closing
Date, the Purchaser will deliver to the Issuer the Subscription Agreement and
all applicable schedules and required forms, duly executed, and payment in full
for the total price of the Securities to be purchased by the Purchaser.

	Subscription Agreement (with related appendices,
      schedules and forms) 	Page 12 of 12 

4.2 At Closing, the Issuer will deliver to the Purchaser the
certificates representing the Securities purchased by the Purchaser registered
in the name of the Purchaser or its nominee, or as directed by the
Purchaser.

5. MISCELLANEOUS

5.1 The Purchaser agrees to sell, assign or transfer the
Securities only in accordance with the requirements of applicable securities
laws and any legends placed on the Securities as contemplated by the
Subscription Agreement.

5.2 The Purchaser hereby authorizes the Issuer to correct any
minor errors in, or complete any minor information missing from any part of the
Subscription Agreement and any other schedules, forms, certificates or documents
executed by the Purchaser and delivered to the Issuer in connection with the
Private Placement.

5.3 The Issuer may rely on delivery by fax machine of an
executed copy of this subscription, and acceptance by the Issuer of such faxed
copy will be equally effective to create a valid and binding agreement between
the Purchaser and the Issuer in accordance with the terms of the Subscription
Agreement.

5.4 Without limitation, this subscription and the transactions
contemplated by this Subscription Agreement are conditional upon and subject to
the Issuer’s having obtained such regulatory approval of this subscription and
the transactions contemplated by this Subscription Agreement as the Issuer
considers necessary.

5.5 This Subscription Agreement is not assignable or
transferable by the parties hereto without the express written consent of the
other party to this Subscription Agreement.

5.6 Time is of the essence of this Subscription Agreement and
will be calculated in accordance with the provisions of the Interpretation
Act (British Columbia).

5.7 Except as expressly provided in this Subscription Agreement
and in the agreements, instruments and other documents contemplated or provided
for in this Subscription Agreement, this Subscription Agreement contains the
entire agreement between the parties with respect to the Securities and there
are no other terms, conditions, representations or warranties whether expressed,
implied, oral or written, by statute, by common law, by the Issuer, or by anyone
else.

5.8 The parties to this Subscription Agreement may amend this
Subscription Agreement only in writing.

5.9 This Subscription Agreement enures to the benefit of and is
binding upon the parties to this Subscription Agreement and their successors and
permitted assigns.

5.10 A party to this Subscription Agreement will give all
notices to or other written communications with the other party to this
Subscription Agreement concerning this Subscription Agreement by hand or by
registered mail addressed to the address given on page 1.

5.11 This Subscription Agreement is to be read with all changes
in gender or number as required by the context.

5.12 This Subscription Agreement will be governed by and
construed in accordance with the internal laws of British Columbia (without
reference to its rules governing the choice or conflict of laws), and the
parties hereto irrevocably attorn and submit to the exclusive jurisdiction of
the courts of British Columbia with respect to any dispute related to this
Subscription Agreement.

End of General Provisions

End of Subscription AgreementAnavex Life Sciences Corp.: Exhibit 10.3 - Filed by newsfilecorp.com

EXHIBIT A

THE SECURITIES REPRESENTED HEREBY HAVE BEEN OFFERED IN AN
OFFSHORE TRANSACTION TO A PERSON WHO IS NOT A U.S. PERSON (AS DEFINED HEREIN)
PURSUANT TO REGULATION S UNDER THE UNITED STATES SECURITIES ACT OF 1933, AS
AMENDED (THE "1933 ACT"). 

NONE OF THE SECURITIES REPRESENTED HEREBY HAVE BEEN
REGISTERED UNDER THE 1933 ACT, OR ANY U.S. STATE SECURITIES LAWS, AND, UNLESS SO
REGISTERED, MAY NOT BE OFFERED OR SOLD, DIRECTLY OR INDIRECTLY, IN THE UNITED
STATES (AS DEFINED HEREIN) OR TO U.S. PERSONS EXCEPT IN ACCORDANCE WITH THE
PROVISIONS OF REGULATION S UNDER THE 1933 ACT, PURSUANT TO AN EFFECTIVE
REGISTRATION STATEMENT UNDER THE 1933 ACT, OR PURSUANT TO AN AVAILABLE EXEMPTION
FROM, OR IN A TRANSACTION NOT SUBJECT TO, THE REGISTRATION REQUIREMENTS OF THE
1933 ACT AND IN EACH CASE ONLY IN ACCORDANCE WITH APPLICABLE STATE SECURITIES
LAWS. IN ADDITION, HEDGING TRANSACTIONS INVOLVING THE SECURITIES MAY NOT BE
CONDUCTED UNLESS IN COMPLIANCE WITH THE 1933 ACT. "UNITED STATES" AND "U.S.
PERSON" ARE AS DEFINED BY REGULATION S UNDER THE 1933 ACT. 

THESE WARRANTS WILL EXPIRE AND BECOME NULL AND VOID 
AT 12:00
P.M. ON _______________.

SHARE PURCHASE WARRANTS TO PURCHASE SHARES OF COMMON STOCK
OF

ANAVEX LIFE SCIENCES CORP.

     THIS IS TO CERTIFY THAT
_________________________, (the “Holder”) of _______________SHARE
PURCHASE WARRANTS, has the right to purchase, upon and subject to the terms and
conditions hereinafter referred to, up to ______fully paid and non-assessable
shares of common stock (the “Shares”) in the capital of Anavex Life Sciences
Corp. (hereinafter called the “Company”) on or before 12:00 p.m. on
_______________(the “Expiry Date”) at a price per Share of
US$_______________(the “Exercise Price”) on the terms and conditions attached
hereto as Appendix A (the “Terms and Conditions”).

	 	1. 	
      One warrant and the exercise price are required to
      purchase one share. This certificate represents
      _______________warrants.

	 	 	 
	 	2. 	
      These Warrants are issued subject to the Terms and
      Conditions, and the Warrant Holder may exercise the right to purchase
      Shares only in accordance with those Terms and Conditions.

	 	 	 
	 	3. 	
      Nothing contained herein or in the Terms and Conditions
      will confer any right upon the Holder hereof or any other person to
      subscribe for or purchase any Shares at any time subsequent to the Expiry
      Date, and from and after such time, this Warrant and all rights hereunder
      will be void and of no value.

- 2 -

     IN WITNESS WHEREOF the Company
has executed this Warrant Certificate this _____day of _______________,
2010.

ANAVEX LIFE SCIENCES CORP.

Per:
__________________________
       Authorized
Signatory

APPENDIX A

TERMS AND CONDITIONS dated _______________, 2010, attached to
the Warrants issued by Anavex Life Sciences Corp.

1. INTERPRETATION

1.1 Definitions

In these Terms and Conditions, unless there is something in the
subject matter or context inconsistent therewith:

	 	(a) 	
      “Company” means Anavex Life Sciences Corp. until a
      successor corporation will have become such as a result of consolidation,
      amalgamation or merger with or into any other corporation or corporations,
      or as a result of the conveyance or transfer of all or substantially all
      of the properties and estates of the Company as an entirety to any other
      corporation and thereafter “Company” will mean such successor
      corporation;

	 	 	 
	 	(b) 	
      “Company's Auditors” means an independent firm of
      accountants duly appointed as auditors of the Company;

	 	 	 
	 	(c) 	
      “Director” means a director of the Company for the time
      being, and reference, without more, to action by the directors means
      action by the directors of the Company as a Board, or whenever duly
      empowered, action by an executive committee of the Board;

	 	 	 
	 	(d) 	
      “herein”, “hereby” and similar expressions refer to these
      Terms and Conditions as the same may be amended or modified from time to
      time; and the expression “Article” and “Section,” followed by a number
      refer to the specified Article or Section of these Terms and
      Conditions;

	 	 	 
	 	(e) 	
      “person” means an individual, corporation, partnership,
      trustee or any unincorporated organization and words importing persons
      have a similar meaning;

	 	 	 
	 	(f) 	
      “shares” means the shares of common stock in the capital
      of the Company as constituted at the date hereof and any shares resulting
      from any subdivision or consolidation of the shares;

	 	 	 
	 	(g) 	
      “Warrant Holders” or “Holders” means the holders of the
      Warrants; and

	 	 	 
	 	(h) 	
      “Warrants” means the warrants of the Company issued and
      presently authorized and for the time being
outstanding.

1.2 Gender

Words importing the singular number include the plural and vice
versa and words importing the masculine gender include the feminine and neuter
genders.

1.3 Interpretation not affected by Headings

The division of these Terms and Conditions into Articles and
Sections, and the insertion of headings are for convenience of reference only
and will not affect the construction or interpretation thereof.

- 2 -

1.4 Applicable Law

The Warrant and the terms hereof are governed by the laws of
the State of Nevada and the federal laws applicable therein. The Holder, in the
Holder’s personal or corporate capacity and, if applicable, on behalf of each
beneficial purchaser for whom the Holder is acting, irrevocably attorns to the
jurisdiction of the courts of the State of Nevada.

2. ISSUE OF WARRANTS

2.1 Additional Warrants

The Company may at any time and from time to time issue
additional warrants or grant options or similar rights to purchase shares of its
capital stock.

2.2 Warrants to Rank Pari Passu

All Warrants and additional warrants, options or similar rights
to purchase shares from time to time issued or granted by the Company, will rank
pari passu whatever may be the actual dates of issue or grant thereof, or
of the dates of the certificates by which they are evidenced.

2.3 Issue in substitution for Lost Warrants

	 	(a) 	
      In case a Warrant becomes mutilated, lost, destroyed or
      stolen, the Company, at its discretion, may issue and deliver a new
      Warrant of like date and tenor as the one mutilated, lost, destroyed or
      stolen, in exchange for and in place of and upon cancellation of such
      mutilated Warrant, or in lieu of, and in substitution for such lost,
      destroyed or stolen Warrant and the substituted Warrant will be entitled
      to the benefit hereof and rank equally in accordance with its terms with
      all other Warrants issued or to be issued by the Company.

	 	 	 
	 	(b) 	
      The applicant for the issue of a new Warrant pursuant
      hereto will bear the cost of the issue thereof and in case of loss,
      destruction or theft furnish to the Company such evidence of ownership and
      of loss, destruction, or theft of the Warrant so lost, destroyed or stolen
      as will be satisfactory to the Company in its discretion and such
      applicant may also be required to furnish indemnity in amount and form
      satisfactory to the Company in its discretion, and will pay the reasonable
      charges of the Company in connection therewith.

2.4 Warrant Holder Not a Shareholder

The holding of a Warrant will not constitute the Holder thereof
as a shareholder of the Company, nor entitle him to any right or interest in
respect thereof except as in the Warrant expressly provided.

3. NOTICE

3.1 Notice to Warrant Holder

Any notice required or permitted to be given to the Holder will
be in writing and may be given by prepaid registered post, electronic facsimile
transmission or other means of electronic communication capable of producing a
printed copy to the address of the Holder appearing on the Holder's Warrant or
to such other address as any Holder may specify by notice in writing to the
Company, and any such notice will be deemed to have been given and received by the Holder to whom it
was addressed if mailed, on the third day following the mailing thereof, if by
facsimile or other electronic communication, on successful transmission, or, if
delivered, on delivery; but if at the time or mailing or between the time of
mailing and the third business day thereafter there is a strike, lockout, or
other labor disturbance affecting postal service, then the notice will not be
effectively given until actually delivered.

- 3 -

3.2 Notice to the Company

Any notice required or permitted to be given to the Company
will be in writing and may be given by prepaid registered post, electronic
facsimile transmission or other means of electronic communication capable of
producing a printed copy to the address of the Company set forth below or such
other address as the Company may specify by notice in writing to the Holder, and
any such notice will be deemed to have been given and received by the Company to
whom it was addressed if mailed, on the third day following the mailing thereof,
if by facsimile or other electronic communication, on successful transmission,
or, if delivered, on delivery; but if at the time or mailing or between the time
of mailing and the third business day thereafter there is a strike, lockout, or
other labour disturbance affecting postal service, then the notice will not be
effectively given until actually delivered:

Anavex Life Sciences Corp. 
27
Marathonos Ave. 
15351 Athens, Greece

Attention: President

Fax No. +1 250 764 9701

4. EXERCISE OF WARRANTS

4.1 Method of Exercise of Warrants

The right to purchase shares conferred by the Warrants may be
exercised by the Holder surrendering the Warrant Certificate representing same,
with a duly completed and executed subscription in the form attached hereto and
a bank draft or certified check payable to the Company for the purchase price
applicable at the time of surrender in respect of the shares subscribed for in
lawful money of the United States of America, to the Company at the address set
forth in, or from time to time specified by the Company pursuant to, Section
3.2.

4.2 Effect of Exercise of Warrants

	 	(a) 	
      Upon surrender and payment as aforesaid the shares so
      subscribed for will be deemed to have been issued and such person or
      persons will be deemed to have become the Holder or Holders of record of
      such shares on the date of such surrender and payment, and such shares
      will be issued at the subscription price in effect on the date of such
      surrender and payment.

	 	 	 
	 	(b) 	
      Within ten business days after surrender and payment as
      aforesaid, the Company will forthwith cause to be delivered to the person
      or persons in whose name or names the shares so subscribed for are to be
      issued as specified in such subscription or mailed to him, her or them at
      his, her or their respective addresses specified in such subscription, a
      certificate or certificates for the appropriate number of shares not
      exceeding those which the Warrant Holder is entitled to purchase pursuant
      to the Warrant surrendered.

- 4 -

4.3 Subscription for Less Than Entitlement

The Holder of any Warrant may subscribe for and purchase a
number of shares less than the number which the Holder is entitled to purchase
pursuant to the surrendered Warrant. In the event of any purchase of a number of
shares less than the number which can be purchased pursuant to a Warrant, the
Holder thereof upon exercise thereof will in addition be entitled to receive a
new Warrant in respect of the balance of the shares which the Holder is entitled
to purchase pursuant to the surrendered Warrant and which are not then
purchased.

4.4 Warrants for Fractions of Shares

To the extent that the Holder of any Warrant is entitled to
receive on the exercise or partial exercise thereof a fraction of a share, such
right may be exercised in respect of such fraction only in combination with
another Warrant or other Warrants which in the aggregate entitle the Holder to
receive a whole number of such shares.

4.5 Expiration of Warrants

After the expiration of the period within which a Warrant is
exercisable, all rights thereunder will wholly cease and terminate and such
Warrant will be void and of no effect.

4.6 Time of Essence

Time will be of the essence hereof.

4.7 Subscription Price

Each Warrant is exercisable at a price per share (the “Exercise
Price”) of US$_____. One Warrant and the Exercise Price are required to
subscribe for each share during the term of the Warrants.

4.8 Adjustment of Exercise Price

	 	(a) 	
      The Exercise Price and the number of shares deliverable
      upon the exercise of the Warrants will be subject to adjustment in the
      event and in the manner following:

	 	 	 	 
	 		(i) 	
      If and whenever the shares at any time outstanding are
      subdivided into a greater or consolidated into a lesser number of shares
      the Exercise Price will be decreased or increased proportionately as the
      case may be; upon any such subdivision or consolidation the number of
      shares deliverable upon the exercise of the Warrants will be increased or
      decreased proportionately as the case may be.

	 	 	 	 
	 		(ii) 	
      In case of any capital reorganization or of any
      reclassification of the capital of the Company or in the case of the
      consolidation, merger or amalgamation of the Company with or into any
      other Company (hereinafter collectively referred to as a
      “Reorganization”), each Warrant will after such Reorganization confer the
      right to purchase the number of shares or other securities of the Company
      (or of the Company's resulting from such Reorganization) which the Warrant
      Holder would have been entitled to upon Reorganization if the Warrant
      Holder had been a shareholder at the time of such
  Reorganization.

- 5 -

	 	 		
      In any such case, if necessary, appropriate adjustments
      will be made in the application of the provisions of this Article Four
      relating to the rights and interest thereafter of the Holders of the
      Warrants so that the provisions of this Article Four will be made
      applicable as nearly as reasonably possible to any shares or other
      securities deliverable after the Reorganization on the exercise of the
      Warrants.

	 	 	 	 
	 	 		
      The subdivision or consolidation of shares at any time
      outstanding into a greater or lesser number of shares (whether with or
      without par value) will not be deemed to be a Reorganization for the
      purposes of this clause 4.8(a)(ii).

	 	 	 	 
	 	 (b) 	
      The adjustments provided for in this Section 4.8 are
      cumulative and will become effective immediately after the record date or,
      if no record date is fixed, the effective date of the event which results
      in such adjustments.

4.9 Determination of Adjustments

If any questions will at any time arise with respect to the
Exercise Price or any adjustment provided for in Section 4.8, such questions
will be conclusively determined by the Company's Auditors, or, if they decline
to so act any other firm of certified public accountants in the United States of
America that the Company may designate and who will have access to all
appropriate records and such determination will be binding upon the Company and
the Holders of the Warrants.

5. WAIVER OF CERTAIN RIGHTS AND IMMUNITY OF SHAREHOLDERS,
ETC.

The Warrant Holder, as part of the consideration for the issue
of the Warrants, waives and will not have any right, cause of action or remedy
now or hereafter existing in any jurisdiction against any past, present or
future incorporator, shareholder, director or officer (as such) of the Company
for the issue of shares pursuant to any Warrant or on any covenant, agreement,
representation or warranty by the Company herein contained or in the
Warrant.

6. MODIFICATION OF TERMS, ETC.

6.1 Modification of Terms and Conditions for Certain
Purposes

From time to time the Company may, subject to the provisions of
these presents, modify the Terms and Conditions hereof, for the purpose of
correction or rectification of any ambiguities, defective provisions, errors or
omissions herein.

6.2 Warrants Not Transferable

The Warrant and all rights attached to it are not
transferable.

- 6 -

DATED as of the date first above written in these Terms and
Conditions.

	 	ANAVEX LIFE SCIENCES
      CORP. 
	 	 	  
	 	 	  
	 	 Per: 	
	 	 	Authorized Signatory 

WARRANT EXERCISE FORM

To: Anavex Life Sciences Corp. 

       27 Marathonos Ave.

       15351 Athens, Greece

The undersigned Holder of the within
  Warrants hereby subscribes for ____________shares of common stock (the “Shares”)
  of Anavex Life Sciences Corp. (the “Company”) pursuant to the within Warrants at
  US$_____per Share on the terms specified in the said Warrants. This subscription
  is accompanied by a certified check or bank draft payable to or to the order of
  the Company for the whole amount of the purchase price of the Shares.

The undersigned represents that, at the time of the exercise of
these Warrants, all of the representations and warranties contained in Section 6
of the Subscription Agreement between the Company and the undersigned pursuant
to which these Warrants were issued are true and accurate.

Please register the share certificates as follows:

	Registration Instructions 	 	Delivery Instructions 
	 	 	 
	 	 	 
	Name 	 	Name 
	 	 	 
	 	 	 
	Address 	 	Address 
	 	 	 
	 	 	 
	City 	 	City 
	 	 	 
	 	 	 
	Province or State & Postal Code or Zip 	 	Province or State & Postal Code or Zip
  
	 	 	 
	 	 	 
	  	 	Phone No. 

(Please print full name in which share certificates are to
be issued, stating whether Mr., Mrs. or Miss is applicable).

REPRESENTATIONS AND WARRANTIES

The undersigned is not a “U.S. person”, as such term is defined
in Regulation S as promulgated under the United States Securities Act of 1933,
at the time of the exercise of the Warrants.

LEGENDS

The certificates representing the shares acquired on the
exercise of the Warrants will bear a U.S. legend in substantially the following
form:

	
      THE SECURITIES REPRESENTED HEREBY HAVE BEEN OFFERED IN AN
      OFFSHORE TRANSACTION TO A PERSON WHO IS NOT A U.S. PERSON (AS DEFINED
      HEREIN) PURSUANT TO REGULATION S UNDER THE UNITED STATES SECURITIES ACT OF
      1933, AS AMENDED (THE "1933 ACT"). 

- 2 -

	
      NONE OF THE SECURITIES REPRESENTED HEREBY HAVE BEEN
      REGISTERED UNDER THE 1933 ACT, OR ANY U.S. STATE SECURITIES LAWS, AND,
      UNLESS SO REGISTERED, MAY NOT BE OFFERED OR SOLD, DIRECTLY OR INDIRECTLY,
      IN THE UNITED STATES (AS DEFINED HEREIN) OR TO U.S. PERSONS EXCEPT IN
      ACCORDANCE WITH THE PROVISIONS OF REGULATION S UNDER THE 1933 ACT,
      PURSUANT TO AN EFFECTIVE REGISTRATION STATEMENT UNDER THE 1933 ACT, OR
      PURSUANT TO AN AVAILABLE EXEMPTION FROM, OR IN A TRANSACTION NOT SUBJECT
      TO, THE REGISTRATION REQUIREMENTS OF THE 1933 ACT AND IN EACH CASE ONLY IN
      ACCORDANCE WITH APPLICABLE STATE SECURITIES LAWS. IN ADDITION, HEDGING
      TRANSACTIONS INVOLVING THE SECURITIES MAY NOT BE CONDUCTED UNLESS IN
      COMPLIANCE WITH THE 1933 ACT. "UNITED STATES" AND "U.S. PERSON" ARE AS
      DEFINED BY REGULATION S UNDER THE 1933 ACT. 

DATED this ________day of __________________, ______.

	WITNESSED BY 	 	WARRANT HOLDER 
	 	 	 
	 	 	 
	X 	 	X
  
	Signature 	 	Signature 
	 	 	 
	 	 	 
	Name (Please Print) 	 	Name (Please Print) 
	 	 	 
	 	 	 
	Address 	 	Address 
	 	 	 
	 	 	 
	City 	 	City 
	 	 	 
	 	 	 
	Province or State & Postal Code or Zip 	 	Province or State & Postal Code or Zip
  

INSTRUCTIONS FOR SUBSCRIPTION

The signature to the subscription must correspond in every
particular with the name written upon the face of the Warrant without alteration
or enlargement or any change whatever. If there is more than one subscriber, all
must sign. In the case of persons signing by agent or attorney or by personal
representative(s), the authority of such agent, attorney or representative(s) to
sign must be proven to the satisfaction of the Company. If the Warrant
certificate and the form of subscription are being forwarded by mail, registered
mail must be employed.

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