IMENA COLLECTIVE BUSINESS AGREEMENT

First Name *

Last Name *

Birth Date

Social Security number or business EIN number (for your 1099 form at the end of the year)

Street Address and Apartment Number *

City *

State *

Zip Code

Email Address *

Telephone Number *

Website Address *

Store / Spa / Salon Street Address and Suite number (if applicable) *

City *

State *

Zip Code

How would you like to get paid? Choose an option below. (There may be times when we pay you for services. Please choose your preferred method of receiving payment). *

Paypal

Chase Quickpay

Cash App

Write your email or telephone number attached to your method of payment.