Card Type *

Visa

Mastercard

Discover

Amex

Cardholder Billing Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Authorization *

By checking this box I authorize ETC. by Emily LLC. to charge my credit card above for agreed upon invoices. I understand that my information will be saved to file for future transactions on my account. This authorization will remain in effect until cancelled. To cancel this authorization at any time contact Emily @ (480) 404-5757

Date of Event *

MM

DD

YYYY

Client Name *

First Name

Last Name

Client Phone *

(###)

###

####

In Time

Fill in the hour, minutes and seconds. If you do not fill in all the fields, including the seconds field, the form will give you an error.

Hour

Minute

Second

AM PM

Out Time

Fill in the hour, minutes and seconds. If you do not fill in all the fields, including the seconds field, the form will give you an error.

Hour

Minute

Second

AM PM

Staff

Catering/Banquet Manager

Lead Servers

Servers

Bartenders

Lead Bartender

Set/Strike

Event Host

Kitchen Help

Dishwashers

Concession Worker

Trade Booth Assistant

Check In/Check Out Attendent

Event Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Onsite Contact Name

First Name

Last Name

Contact Phone Day of Event

(###)

###

####

Date of Event *

MM

DD

YYYY

Client Name *

First Name

Last Name

Client Phone *

(###)

###

####

In Time

Fill in the hour, minutes and seconds. If you do not fill in all fields, including the seconds field, the form will give you an error.

Hour

Minute

Second

AM PM

Out Time

Fill in the hour, minutes and seconds. If you do not fill in all fields, including the seconds field, the form will give you an error.

Hour

Minute

Second

AM PM

Staff

Catering/Banquet Manager

Lead Servers (Captain)

Servers

Bartenders

Lead Bartender

Setup/Strike

Event Host

Kitchen Help

Dishwashers

Concession Worker

Trade Booth Assistant

Check In/Check Out Attendent

Event Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Onsite Contact Name

First Name

Last Name

Contact Phone Day of Event

(###)

###

####

Date of Event *

MM

DD

YYYY

Contact Phone Number

If you're registered with ETC. you can leave this blank.

(###)

###

####

In Time *

Fill in the hour, minute and seconds. If you do not fill in all fields, including the seconds field, the form will give you an error.

Hour

Minute

Second

AM PM

Out Time *

Fill in the hour, minutes and seconds. If you do not fill in all fields, including the seconds field, the form will give you an error.

Hour

Minute

Second

AM PM

Event Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Onsite Day of Event Contact Name

First Name

Last Name

Contact Phone Day of Event

(###)

###

####