Time & Materials Client Sign Up - St. Louis IT Support

Our goal is to be the one-stop shop for all the IT needs of any small to medium size business. Our primary focus and priority is on our managed clients that have partnered with us through a monthly support agreement. You can click here to learn more about this partnership.

With that being said, we will provide one-time services to companies that would like to "try before they buy". In order for us to engage in this type of relationship, we will need you to complete the form below along with a valid payment method before we can create a support request.

Full Name:*
Company Name:*
Email*
Phone*
Business Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Number of Employees*
Website
Payment Information
In order for us to create your support request, we will need to secure a payment method on file. If we do not receive payment prior to the invoice due date, we will process your payment on the due date of your invoice. Please also note we cannot process your support engagement if this form is incomplete.
How will you be paying?*
- Credit Card
- ACH (bank account)
Type of Credit Card:*
- Mastercard
- Visa
- Discover
- AMEX
NOTE: Credit Cards will incur a 3% processing fee. You have the option to pay via check/ACH prior to the due date and we will only process the credit card on file if we have not received payment by the due date.
Credit Card Number:*
Name on Credit Card:*
Expiration Date:*
MM/YYYY
CVV*
3 digit number on the back of the card
Bank Name:*
Bank Account Number:*
Bank Routing Number:*
9 Digits
Agreement Terms:

By clicking the checkbox below, you are agreeing to the above payment processing terms. You are also agreeing to the terms and expectations listed in our Time and Materials Agreement and Master Service Agreement.
*
- I Agree

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New Time & Materials Client Sign Up Form

Payment Information

Agreement Terms:

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