Rapid! PayCard Enrollment Form

You are eligible to be paid Per Diem at an upcoming C3 Event so please review and sign this form so we can issue you a personalized Rapid!

PayCard. Rapid PayCards work like a pre-paid gift cards. You can use it anywhere that accepts VISA to make purchases (up to the amount that is on the card) and you will be able to transfer money from the card to your bank account with no fees using the Rapid! PayCard app. More information about how to activate and use these cards will be included when the card is sent to you. If you have any questions, you can contact us at Rapidpay@collectivepayroll.com anytime.

Cardholder Acknowledgement*

I acknowledge that I am receiving a Rapid! PayCard for C3 Presents and Collective Payroll to issue my Per Diem payments only. (Your payroll wages will not be issued to this card).

I acknowledge that it is my responsibility to keep this card in case I am eligible to receive Per Diem payments at a future C3 event. I acknowledge that replacement cards are available. I understand that requesting a replacement may cause a delay in Per Diem payouts.

I ackowledge that there are no fees for purchases or transfer funds to my bank account but there is a fee to use the PayCard at an out-of-network ATM.

I acknowledge that this is a personalized bank card but it is pre-funded so it’s my responsibility to keep this card safe. Lost/Stolen cards should be reported immediately to Rapid Pay Customer Service 877-380-0980 as well as emailing Rapidpay@collectivepayroll.com.

I acknowledge my eligibility and the amount of my per diem is calculated by my C3 Hiring Manager. If my onsite dates change and results in an overpayment of Per Diem, I hereby authorize Collective Payroll or their respective agents, to withhold the balance from my net pay when my payroll check is issued.

Signature (Please type name)*

Last Name*

First Name*

Address Line 1*

Note: Your card will be delivered via UPS to this address so please make sure you enter it correctly to avoid any shipping delays. If you will not be home prior to the event - enter your home address for the record and then email us after you submit the form for another delivery option.

City*

State*

Zip*

DOB*

**Please enter your Date of Birth in the following format with the year first: YYYYMMDD

SSN*

**Please enter your Social Security Number with no dashes and no spaces

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