Blank Form (#5)

Public Employee Virtual
Appointment Order Form

Basic price per appointment is a $49, but after we give you 12% discount which will be applied to the entire invoice to cover cancellations whether the Agent have them or not. So, the agent’s actual cost is $43.12 and that what we are going to charge per appointment. By checking the appointment Order box, the undersigned agent hereby agrees to comply with all terms and conditions of this agreement and is requesting a weekly order that will continue until agent provides Public Employee Virtual Appointments with a written notification to cancel next order. A minimum of two weeks’ cancellation notice is required. Upon cancellation by the Agent, all appointments generated for the Agent must be purchased by Agent at a cost of $43.12 per appointments. I hereby authorize Public Employee Virtual Appointments to charge $43.12 per appointment generated from this order. Please note, that all orders are final and non-refundable.
At the end of the week, we will charge your credit card for the actual number of appointments.
Number of weekly appointments could be adjusted on request.