Marin Bookkeepers Referral Network

 Job Referral Request - I have read the Disclaimer ____ (Please initial)

Please print, complete and fax to 415 382-5605.

If this form does not print correctly, please copy and paste it into a Word document.

Contact Name         ______________________________________________

 Company Name      ______________________________________________

 Brief description of bookkeeping services needed:

 ______________________________________________________________

 ______________________________________________________________

 ______________________________________________________________

Type of accounting software used_________________________________

 Description of any special requirements____________________________

 ______________________________________________________________

 Estimate of time requirements (please circle and fill in the blank)

 Number of hours per week/month:  ____________________

 Number of days per month:              ____________________

 Flexible hours?   Yes            No

 Comments  _____________________________________________________

 Location of work    City ___________________________________________

 Offsite (bookkeepper’s office)     Yes         No

 How do you wish to be contacted by prospective bookkeepers?

 ___ Phone     Phone number           ___________________________________

___ Fax          Fax number                ___________________________________

___ Email      Email address           ___________________________________

___ Mail         Address                     ___________________________________

                                                            ___________________________________

                                                            ___________________________________

 How did you find out about our network?_______________________________