Office Application Form ⋆Via Avalon Executive Suites

PLEASE SELECT DESIRED LOCATION:

Via Avalon Office

*Location Required: 6809 Indiana Ave, Riverside CA or 765 North Main Street, Corona CA

How Did Your Hear About Via Avalon?:

Individual/Principal Information

Name:

Phone Number:

Email:

Home Address:

City: State:

Zip:

Business Information

Company Name:

Business Phone:

Business Address:

City: State:

Zip:

Entity: Individual/Sole ProprietorCorporationPartnershipLLC

Type of Business/Service:

Year Established:

Tax ID/SSN:

Website:

Billing Contact:

Contact Phone:

Office Plan of Interest

Select One: Full TimeBronze Virtual

If Full Time, Office # Requested:

Rental Rate Quoted

Type Of Lease: 12-Month6-MonthMonth-to-Month

Desired Start Date:

The name under which the contract will be written (Business/Individual Name):

Are there any other accommodations desired (including occasional)? YesNo

If so, please identify:

If part-time or virtual, how often would you like your mail and/or packages forwarded?
There is a fee for mail forwarding. If not stated, we will hold all mail and packages until you notify us.

Additional Persons

Each plan is designed for 1 person. Each additional person in the office more than 8 hours per month is an additional $100/mo. The Virtual Plan office hours may be shared by more than 1 person if all parties are affiliated with the same Corporation, Partnership, or LLC. Each additional person in the Virtual Plan is an additional $25/mo.

Number of additional people in your plan: (list additional people below).

Name

Phone Number

Email

Current/Past Landlord Reference

Name

Phone Number

Rent Paid

Address:

Termination Date:

**Please provide a copy of your driver’s license and business card.

Please select documents to submit with your application:

Signature

I acknowledge and agree that by typing my name in the box below to electronically sign this form, I am affirming the information requested on the form is true and correct and that I am authorized to submit this application for the person(s) or business(es) listed above and my name below will serve for the purpose of an authorized signature to this application.
Accept? (application can not be submitted without checking this box)

Signature (type full name): Date:

Title/Relationship to Applicant:

Office Application Form

Please fill out the information below to submit your application for Office Space or a Virtual Plan.