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Virtual Administrator Request Form
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Company/Organization Name
*
Business Website / URL
*
Contact Person Name
*
First
Last
Email
*
Phone
*
Date Requesting Services to Start. Date / Time
*
Date
Time
Number of Days
*
Number of Admin Needing
*
Industry
*
Summarize Administrative Services Needed
*
Any Special Requests/Instructions
Ready to move forward and pay for services (needing someone within 48 hours? complete this step)
*
Yes
No
Need a consultation first
Services Requesting
Setup Fee - $250.00
VA 25 Hours-Prepaid - $250.00
VA 40 Hours- Prepaid - $500.00
VA 80 Hours Prepaid - $1,000.00
Total
$0.00
Would you like to be billed for multiple admin?
*
Yes
No
How Many More Admins?
How Many More Hours Total to be billed
Payment Info
Signature
Clear Signature
Submit
