Networking Work Request
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Email *
First Name *
Last Name
Company Name
check one *
CUSTOMER: Phone and/or extension number
CUSTOMER: Street, Town, Zip
Description of Services *
CUSTOMER:  I understand payment is due in full to picking up job requested.*** Scholarship Fee: In lieu of labor charges a scholarship fee will be applied to the total bill.The scholarship fund  assists students with continuing education, tools and supplies. A $5 fee will be applied on orders at $50 and under. Jobs over $50 will be charged 10% of total charges.  Enter your name below to indicate you have read and understand the payment policy.
 *
CUSTOMER: I make this disclosure pursuant to G.L.c.268 A,?23 (b)(3) in order to dispel any appearance of potential conflict of interest, that I may beimproperly or unduly influenced in the performance of my official duties, or that I would be likely to act or fail to act as a result ofkinship, rank, position or the undue influence of any part or person.I publicly Disclose the Following Facts (Please be Specific):
 *
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