Sculpting Tech Legal Name (must match name tied to bank account) *
Sculpting Tech Legal Name (must match name tied to bank account)
Example: July 1st - July 14th, 2017
If Over $25, Must be Previously Approved
$
This form lists 20 client records only, depending on number of sessions performed you may need to submit more than 1 form Example: Form 1 of 2
Client 1
1 - Date of Services Performed
1 - Date of Services Performed
1 - Client Name
1 - Client Name
Applies to Groupon/Living Social Only
1 - Did you Guide the Client to Purchase a Treatment Plan or Product?
This applies to first time clients as well as current clients who purchased additional packages
Example: Breast Lift + Upper Back, Session 1 of 8
Applies Only to Credit Card Transactions
$
Client 2
2 - Date of Services Performed
2 - Date of Services Performed
2 - Date of Services Performed
2 - Date of Services Performed
Client 3
Date of Services Performed
Date of Services Performed
Client 4
Date of Services Performed
Date of Services Performed
Client 5
Date of Services Performed
Date of Services Performed
Client 6
Date of Services Performed
Date of Services Performed
Client 7
Date of Services Performed
Date of Services Performed
Client 8
Date of Services Performed
Date of Services Performed
Client 9
Date of Services Performed
Date of Services Performed
Client 10
Date of Services Performed
Date of Services Performed
Client 11
Date of Services Performed
Date of Services Performed
Client 12
Date of Services Performed
Date of Services Performed
Client 13
Date of Services Performed
Date of Services Performed
Client 14
Date of Services Performed
Date of Services Performed
Client 15
Date of Services Performed
Date of Services Performed
Client 16
Date of Services Performed
Date of Services Performed
Client 17
Date of Services Performed
Date of Services Performed
Client 18
Date of Services Performed d
Date of Services Performed d
Client 19
Client Name
Client Name
Client 20
Date of Services Performed
Date of Services Performed