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Application for Independent Contractor • Rich World Wide Employment

Please complete this form in its entirety for consideration.



	Full Name*
	Other Names Used
	Email Address*
	Business Name or DBA
	Full Address*
	Phone Number*
	Cover Letter Text Please use the following space for your cover letter. You may provide a brief introduction to your qualifications.
	RESUME TEXT Please use the following space to cut and paste your resume text if you wish. Please note that any information not found here MUST be completed below. You may skip the sections below if that information is included in your resume text.
	Education Level* High School Some College Completed 2 year degree Completed 4 year degree Post graduate degree
	Degrees or certifications*
	High School and higher educations institutions* Please list name, address, and number of years attended.
	EMPLOYMENT BACKGROUND Current or most recent employer
	Employer Name*
	Employer Address*
	Employer Phone*
	Your position or title*
	Please describe your responsibilities and duties*
	Supervisor
	Dates of employment (month and year)*
	Reason for leaving*
	Prior employer
	Employer Name
	Employer Address
	Employer Phone
	Your position or title
	Please describe your responsibilities and duties
	Supervisor
	Dates of employment (month and year)
	Reason for leaving
	Prior employer
	Employer Name
	Employer Address
	Employer Phone
	Your position or title
	Please describe your responsibilities and duties
	Supervisor
	Reason for leaving
	Prior employer
	Employer Name
	Employer Address
	Employer Phone
	Your position or title
	Please describe your responsibilities and duties
	Supervisor
	Professional References - You must list three professional references for consideration Reference Number One
	Reference Name*
	Number of years known*
	How known*
	Full address*
	Phone number*
	Reference Number Two
	Reference Name*
	Number of years known*
	How known*
	Full address*
	Phone number*
	Reference Number Three
	Reference Name*
	Number of years known*
	How known*
	Full address*
	Phone number*
	Have you ever worked from home?* yes no
	Why do you feel that you would be good at this position:*
	Why is Rich Enterprises, Inc. a good fit for you?*
	How many hours would you like to work per week?
	Are you seeking an hourly position (without commissions)?
	What is your minimum hourly billing rate?
	Are you seeking an commission based position (without an hourly rate)?
	May we contact your present employer?* yes no
	May we contact your previous employers?* yes no
	May we contact all references listed above? * yes no
	Have you ever been convicted of a felony?* yes no
	How did you hear about us?
	Do you authorize Rich Enterprises, Inc. to pull your credit report? * yes no
	Is there anything in your background that would cause us to question your honesty, ethics, or integrity?* yes no
	By completing this form, I authorize Rich Enterprises, Inc. to verify any information contained in the application. I understand that any false statements included in the application can immediately disqualify me for consideration. * yes no