Payment Request Form
Caregiver Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Date of Job
*
-
Month
-
Day
Year
Date
Name of Church or Event Worked
*
Please include name of Client. Example: Wedding Event for Southern Sitters, Amy Keys Church
Number of Hours You Were Scheduled/Booked to Work
*
(Example: 12pm-4pm; 4 hours)
Number of Hours You Actually Worked
*
(Include any approved overtime, or additional hours if applicable)
Agreed-Upon Hourly Rate for This Booking
*
Total Amount Requested for Payment
*
Was a Bonus Offered for Accepting This Booking?
*
Yes
No
If yes, what was the bonus amount?
*
Please upload a screenshot confirming the bonus amount (approved by an admin).
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Have you completed a W-9 for Southern Sitters?
*
Yes
No
I am not sure.
Venmo Name
*
PayPal Name
*
Any Notes or Additional Information We Should Know?
Submit
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