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Independent Representative Application

Complete this form to be considered for an Independent Representative opportunity with LRE.

Our policy is to provide equal opportunity to all qualified persons without regard to race, creed, color, religious belief, sex, age, national origin, ancestry, physical or mental disability, or veteran status.

 

Date you can start

How did you hear about LRE?

First Name    Last Name    Middle Initial

Street Address

City    State    Zip

How long have you lived at present address?

Phone    Email

S.S.# (optional)     Are you over 18 years of age?............... 

Are you a U.S. citizen or otherwise authorized to work in the U.S. on an unrestricted basis?
(Documentation may be required.)................................................................................................................ 

Have you been convicted of a crime? (This will not necessarily affect your application)

If yes, please describe conditions

Are there any conditions which preclude you from working at Live Reps Events? If so, list them here:

Work History
(Start with most recent)

Company Name

Address    Phone

Date Started   Starting Wage   Date Ended   Ending Wage

Name of Supervisor    May we contact?............... 

Responsibilities

Reason for Leaving

 

Company Name

Address    Phone

Date Started   Starting Wage   Date Ended   Ending Wage

Name of Supervisor    May we contact?............... 

Responsibilities

Reason for Leaving

 

In addition to your work history, are there other skills, qualifications, or experience that we should consider?

Communications    Sales/Retail

Bilingual    Computer Skills

 

Education
(School Name and Location)

High School    Year(s)   Did you graduate?

College    Year(s)     Major
   Did you graduate?

Other Training    Year(s)     Major
   Did you graduate?

 

Military
(Complete this section if you served in the U.S. Armed Forces)

Did you serve in the U.S. Armed Services?

Date of Final Discharge

 

References

Name    Business

        Phone    Years Aquainted

Name    Business

        Phone    Years Aquainted

Name    Business

        Phone    Years Aquainted

 

Do you have any physical, mental or health issues that would prevent you from working a full schedule week after week? If so, list them here:

The information provided in this application, to the best of my knowledge, is true, accurate, and complete. I understand that any misstatements or omissions of fact may result in the cancellation of our working agreement. I also understand that acceptance of an offer does not create a contractual obligation upon Live Reps Events. If LRCE decides to engage an investigative consumer reporting agency to report on my credit and personal history, I authorize LRCE to do so. If a report is obtained, at my request, LRCE must provide the name and address of the agency so I may obtain from them the nature and substance of the information contained in the report.