Telephone Representative Application

Personal Information

Email(Required)

Cell Phone(Required)

Home Phone

Birthdate(Required)

SSN#(Required)

Goals

What Are Your Annual Income Goals?(Required)

How Committed Are You To Achieving The Above Income Goal?(Required)

What is the earliest date that you can start?(Required)

Do you prefer to work independently or as a team?(Required)

Employment History

Are you currently employed?(Required)

Please enter your most recent three employers (if applicable):

Most Recent Employer

Employer(Required)

Start Date(Required)

End Date(Required)

Position(Required)

Reason For Leaving(Required)

Second Most Recent Employer

Employer(Required)

Start Date(Required)

End Date(Required)

Position(Required)

Reason For Leaving(Required)

Third Most Recent Employer

Employer(Required)

Start Date(Required)

End Date(Required)

Position(Required)

Reason For Leaving(Required)

How Do You Rate Yourself?

1 BEING THE LOWEST & 5 BEING THE BEST

In your own words, tell us more about yourself. Things that you feel we should consider:(Required)

Education Information

What is the Highest Grade or Level of School the Completed?(Required)

GED • High School • College/Number of Years

What Degree(s) if any?(Required)

Associate Degree • Bachelor's Degree • Master's Degree • Doctoral Degree

Follow Up Information

How did you hear about us?(Required)

If other, what website referred you to us?

Legal Disclosures

Have you ever been convicted of a felony?(Required)

Please Explain(Required)

Have you ever been convicted of a misdemeanor?(Required)

Please Explain(Required)

All information contained on the application is subject to verification. If applicable, Outreach Marketing LLC may conduct background checks including, but not limited to, work references, driving records, criminal conviction records and educational attainment. You may be subjected to a criminal background investigation for some positions. All offers of employment and continued employment may be subject to a complete review of any criminal convictions you may have. Your failure to make a full and accurate disclosure of any prior conviction(s), or to answer the questions fully and accurately, may result in immediate termination from employment or the rejection of any pending application or offer from Outreach Marketing LLC.

I certify that all the information provided herein is true and complete to the best of my knowledge. I agree and understand that omissions, misstatements and falsifications may cause forfeiture on my part of all eligibility to any employment with Outreach Marketing LLC and may be cause for rejection of this application, or dismissal from employment. In addition, I give Outreach Marketing LLC the right to investigate and verify any information obtained through the application process. Permission is granted and I release from any and all liability any employer, agency, individual or educational institution assisting the Outreach Marketing LLC in providing relevant, job-related information that will assist in the process.

Signature(Required)

Personal Information

Goals

Employment History

Most Recent Employer

Second Most Recent Employer

Third Most Recent Employer

How Do You Rate Yourself?

Education Information

Follow Up Information

Legal Disclosures

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