PRIVATE OFFICE MEMBERSHIP PURCHASE FORM

How Did You Find Us? *

This lets us know who to thank if you were a referral or what marketing is working. Your input matters to us. Thanks for helping us out.

Today's Date That Starts Your Membership *//

Name *

First

Last

Business or Organization Name (if applicable)

Website / URL (if you have one)

Personal Cell Phone

Business Phone

Best Email for Billing Receipts & Member Info *

Best Business Email (The one you publish for customers)

Address

Address Line 1

Address Line 2

City

State

Zip Code

Type of Membership *

($700) Private Office

Would you like more information about any of our business service add-ons?

Business Phone Number Including Top Free Numbers
Business Mailing Address (Not for Google Business)
Live Answer Receptionist Service

Total

$ 0.00

Stripe Credit Card *

Card

Name on Card

Signature *

By signing, I signify that I have read the coworking agreement and will follow the guidelines. I understand my failure to do could result in the loss of my membership privileges. My signature also gives the authorization to bill me monthly on recurring membership. My signature also acknowledges that memberships are month to month and can be changed by owner at any time and notice before the next billing cycle will be given. My signature also acknowledges that regular coworking hours are Monday-Friday from 8am-5pm and I am being provided bonus hours outside of that time with the understanding that it is not disturbing to those that are renting other areas in the coworking space and that I will shut down lights, adjust thermostats according to guidelines and lock the door when leaving.

Name