Home Contracted Vendor Application - Work from home jobs ...



DionData Solutions Home Contracted Vendor Application** We do not accept applications outside of the U.S. **Due to the overwhelming responses from applicants unfortunately DionData Solutions will not be able to respond to every application received. You will hear from us when your application is approved. Thank you for your interest in DionData Solutions. Last Name: ________________M.I._____First Name: __________________Address: _______________________________________________________________City: __________________State: _______ Zip Code: __________ Time Zone_______Phone Number: _____________________Fax Number_________________________**Copies of Drivers License and SSN will be requested upon approval for services so you may receive a 1099 at the end of the year.How did you hear about us? Rat Race RebellionWork at home list group(s) you are on: Rat Race Rebellion _______________________________________________________________E-Mail Address__________________________________Yahoo ID________________ Work/Vendor History: Start with most recent:#1: Company Name: ______________________________Type of Business: ________________________________From________To________Address: ________________________________________________________________Phone Number: ____________________Job Description: ________________________Supervisor: _________________May we contact the above? Yes_____No______#2: Company Name: _____________________________Type of Business: _______________________________From________to________Address: ________________________________________________________________Phone Number: ______________________Job Description: ______________________Supervisor: ___________________May we contact the above?Yes_____No______Hours of Availability: Please state in relation to CST in the U.S. From ToDays: _________ _________Evenings: _________ _________Nights: _________ _________List days you are not available: ____________________________Weekend Availability: ____________________Holidays: Yes____ No____Personal References (No family members):1. Name__________________ Relationship_____________ Yrs. Known______Phone Number_____________________E-mail address (if applicable)_____________________2. Name__________________Relationship____________Yrs. Known_______Phone Number____________________E-mail address (if applicable)______________________Education:High School Graduate: Yes____ No____ GED____College: ________________________________Degree: ________________________Trade School: _______________________________________________Course of Study: _____________________________________________Skills: __________________________________________________________Typing Speed________WPM Data Entry KSPH__________**If you are unsure, please visit a typing test website and include a copy of the results with your application.Do you have any special skills related to becoming a Home Contracted Vendor? ____________________________________________________________________Are you experienced in Windows Virtual PC? _____________________________________List Computer(s), Laptop(s) and their Win OS along with other Office Equipment you currently have: _____________________________________________________________________________________________________________________________________________Current ISP Connection: Cable____ DSL_____Current Windows Application: XP ___ Win 7 Pro____ Win 10 Pro_____Other: ________________Signature________________________Date_______________ (Electronic Typed Signature)* This is an electronic signature and is given in accordance with the U.S. Federal regulations (ESIGN Act) governing the legal and binding effectiveness of electronic signatures. "This message and accompanying documents are covered by the Electronic Communications Privacy Act, 18 U.S.C. Ch.119 Sections 2510-2521 et seq., and contains information intended for the specified individual(s) only. This electronic communication and any attachments may contain confidential and proprietary information of DionData Solutions and its Clients. If you are not the intended recipient or an agent responsible for delivering it to the intended recipient, you are hereby notified that you have received this document in error. Any review, dissemination, copying, or the taking of any action based on the contents of this information is strictly prohibited. If you have received this communication in error, please notify the sender immediately by e-mail, and delete the original message. DionData Solutions reserves the right to monitor any electronic communication sent or received by its vendors, employees, agents or representatives."Copyright 1999-present. All Federal and State laws apply to the copyright laws governing this document. Full written consent is required to copy or use this material belonging to DionData Solutions. Revised 02012018 ................
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