New Client – Campaign Solutions | A Full-Service Digital Consulting Firm

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Client Name:

Official Client Name:

Street Address:

Street Address 2:

City:

State:

Zip Code:

Federal Tax Employer Identification Number (EIN):

ABA Routing Number:

Recipient Account Number:

Account Type:

Contact Email (for statements):

Is this a Nancy Watkins Client?:

Setup Fee:

Setup Fee Other Amount (If Necessary):

Hosting Fee:

Hosting Fee Other Amount (If Necessary):

Will this client be billed hourly or have a retainer?:

If client will be billed, what is the hourly rate or retainer (including # of hours included in reainer)?:

Type:

Other Type:

Is this a "cost plus" customer?:

Main %:

Processing / Events %:

Revenue Share %:

If this is NOT a "cost plus" customer, please provide details:

Staff Member responsible for this Client:

Notes / Special Instructions:

Contract: