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eugene@barewebdesign.com
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Client Account Set Up Form
This secure form to share your access information and billing set up.
Name
(Required)
First
Last
Address
(Required)
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Business Name
(Required)
Website
Login Information
Please list user names and passwords for your website, hosting account, social media or other online accounts you wish to have work done on.
Payment Method
Card Number
(Required)
Exp.
(Required)
CVV
(Required)
3-4 Digit code found on back of card
Address Associated With Payment
(Required)
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Consent
(Required)
I agree
Beginning in 2024 all monthly retainer, domain name registration, privacy and hosting charges will be auto billed to a payment method attached to a clients account.
Agreed upon website maintenance plans, hourly support requested, and other expenses expected by the client will also be billed automatically.
Large projects, new websites and any non-standard or agreed upon charges will NOT be made to the card on file without approval by the client.
You will never billed or charged you for any service without being agreed upon in writing previously.
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