Application

If you are interested in joining the Community Representatives Network, please fill-out the application below.

Should you meet our program criteria, we will send you all the necessary material so you can start your own e-business as a Community Representative!

Note: The fields marked with * are required.

Personal information

* First Name :

* Last Name:

* Address:

* City:

* Province/State:

* Country:

* Postal/Zip code:

* Telephone:

Fax:

* E-mail:

 
Circle of influence

* In what area(s) would you feel confident in introducing our services?

For multiple selections,
PC - hold down
<Ctl> key
Mac - hold down
<Command> key

Other areas:

 

Business experience

* Current /
Last Employer:

Start Date:

Date of departure:

* What fields have you worked in before?

For multiple selections,
PC - hold down
<Ctl> key
Mac - hold down
<Command> key

Have you worked as an independent contractor before?

Yes No

* Please tell us why you feel are a good Community Representatives candidate. (2-4 sentences)

 

Miscellaneous

How many hours are you on the Net weekly?

* Do you have a Web site?

Yes No

* If yes, what's the Web address?:

Other comments:

* If referred by a CR, please enter ID#:

I found out about the CRN program from:

   

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