This is our online form to sign up for virtual executive assistant service. If you are only interested in learning more, please go to https://calendly.com/worxbee/learn to schedule a call.
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General Information

 
First Name *

 
Last Name *

 
Company

 
Best phone number to reach you *

 
Complete Mailing Address *

 
Physical Address (If different from mailing)

 
How did you hear about Worxbee?


 
Type of service you are signing up for: *


 
How many hours of virtual executive assistant service per month would you like to sign up for: *


 
Legal Details

 
I agree to the terms and conditions of this service agreement. *

Service Terms and Conditions: http://bit.ly/WORXBEEGeneralAgreement

Client Amendment(s): (1) Worxbee will identify two (2) service experts who fit the client’s needs. The client will be able to review the service experts’ bios and conduct phone interviews prior to the pairing. If the client is unsatisfied with the performance of his or her service expert, the client must provide written or electronic (i.e. email) notice within a reasonable time to Worxbee management. If Worxbee management agrees it is a service issue on the behalf of the service expert that cannot be corrected with coaching, Worxbee will reassign the client to a new service expert within five (5) business days.
Service Terms and Conditions: http://bit.ly/WORXBEEGeneralAgreement

Client Amendment(s): (1) Worxbee will identify two (2) service experts who fit the client’s needs. The client will be able to review the service experts’ bios and conduct phone interviews prior to the pairing. If the client is unsatisfied with the performance of his or her service expert, the client must provide written or electronic (i.e. email) notice within a reasonable time to Worxbee management. If Worxbee management agrees it is a service issue on the behalf of the service expert that cannot be corrected with coaching, Worxbee will reassign the client to a new service expert within five (5) business days.
     
 
Schedule A: I am signing up for {{answer_46097813}}of {{answer_46097619}}. *

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RECURRING PAYMENT FORM You authorize regularly scheduled charges to your credit card, checking account, or savings account. You will be charged the amount indicated on Schedule A each billing period. The charge will appear on your bank statement as a charge from WORXBEE.COM You agree that no prior notification will be provided unless the amount changes, in which case you will receive notice from us at least 5 days prior to the payment being collected. 
 Please complete the information below: 
 I, {{answer_nE0Q}} {{answer_BcPN}}, authorize Uniquely Virtual to charge my account indicated on Schedule A on the recurring date of service each month. *

I understand that this authorization will remain in effect until I cancel it, and I agree to notify Worxbee in writing of any changes in my account information or termination of this authorization at least 15 days prior to the next billing date. If the above noted periodic payment dates fall on a weekend or holiday, I understand that the payment may be executed on the next business day. I understand that because this is an electronic transaction, these funds may be withdrawn from my account as soon as the above noted periodic transaction dates. In the case of an ACH Transaction being rejected for Non-Sufficient Funds (NSF) I understand that Uniquely Virtual may at its discretion attempt to process the charge again within 30 days, and agree to an additional $25 charge for each attempt returned NSF which will be initiated as a separate transaction from the authorized recurring payment. I acknowledge that the origination of ACH transactions to my account must comply with the provisions of U.S. law. I agree not to dispute this recurring billing with my bank so long as the transactions correspond to the terms indicated in this authorization form.
I understand that this authorization will remain in effect until I cancel it, and I agree to notify Worxbee in writing of any changes in my account information or termination of this authorization at least 15 days prior to the next billing date. If the above noted periodic payment dates fall on a weekend or holiday, I understand that the payment may be executed on the next business day. I understand that because this is an electronic transaction, these funds may be withdrawn from my account as soon as the above noted periodic transaction dates. In the case of an ACH Transaction being rejected for Non-Sufficient Funds (NSF) I understand that Uniquely Virtual may at its discretion attempt to process the charge again within 30 days, and agree to an additional $25 charge for each attempt returned NSF which will be initiated as a separate transaction from the authorized recurring payment. I acknowledge that the origination of ACH transactions to my account must comply with the provisions of U.S. law. I agree not to dispute this recurring billing with my bank so long as the transactions correspond to the terms indicated in this authorization form.
     
 
Service Details

 
What are your top three administrative needs?

 
How do you like to communicate?


 
Please describe your communication style.

 
Please tell us which platforms you use. (Email, CRM, Bookkeeping like Google, Office, QuickBooks, Sage, SalesForce)

 
Is anyone else authorized to use your account? *

     
 
Authorized User(s) General Information

 
There is an administrative fee of {{var_price}}. It will be credited towards your first month of service with Worxbee. *

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