Agents - Application
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Agent Application



Agents - Application

We are actively seeking new agents to join our growing team. If you are interested in working with B2B, we invite you to fill out the following agent application to get started.


  Agents Application

Name:

Contact Information:

Current Address:

Previous Addresses For The Past 3 Years:


In Case of Emergency Notify:

Have You Worked For This Company Before?

    Yes
    No

If So, In What Position?

Dates:

Reason for Leaving:

Names of Relatives in our Employ

Are You Currently a Broker Agent?

    Yes
    No

Do You Have A Current Book of Business?

    Yes
    No

What Is Your Current Annual Revenue?

What Is Your Average Profit Margin?

What Is Your Projected Annual Revenue For The Next 12 Months?

How Did You Hear About Us?

Are You Eligible To Work In The United States?

    Yes
    No

  Work History
List names of employers in consecutive order with present or last employer listed first. If self-employed, give firm name and supply business references. If you worked in any of position under another name, please give name(s).


Last Employer or Broker

Position Held

Dates:

Reason for Leaving:


Second Last Employer or Broker

Position Held

Dates:

Reason for Leaving:


  Experience & Qualifications - Office
List applications and training courses completed:

PC Miler for Windows Truck Settlements
Brokarage Dispatching

List any other computer programs you have used that are not listed above then explain type of program

List any Seminars, Workshops, or School Courses you have attended.


  References
Give three references, not relatives or former employers.

  Additional Information
If there is any additional information you would like to share with us regarding your skills, experience or attributes, please include that information below:


Electronic Signature

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