"Lifeline" Application Form

Williams Marketing and Management, Inc

First NameLast Name

Legal Name (must match ID/DL)

First NameLast Name

Phone Number*

ex: 123-456-7890

Email Address (No Gmails Allowed)*

NO GMAIL ADDRESS ALLOWED

Program(s) To Apply For*

LifeLine ProgramsInternet ProgramsACA Programs

Desired Sales Position

Select your desired market below.

"Travel outside of 30 miles from your local could be required for work related purposes. Including, but not limited to recieving inventory and/or work equipment."

LifeLine Programs*

Internet Programs*

ACA Programs*

Leaders Name/ Referral?*

Agent Name*

Own a smart phone or tablet with data?*

Have you done Sales Before?*

What Sales Company(s)? / Why did you leave?*

I'm aware this is commission only?*

Can You Pass A Background Check?*

No Felony Charges Allowed

Available Work Schedule*

How Soon Can You Start Training?*

Training Location Sent Via Email

Best Time To Reach You*

In order to participate in the Lifeline Program you must have a Radid number. Please provide your Radid Number below. If you need to register for your Radid, please go back to the Join Our Team Page of the company Website.

RADID NUMBER

Birthday*

MonthDayYear

What makes you a great fit for our organization? *

_{THIS IS A 1099 INDEPENDANT CONTRACT POSITION ONLY.}

_{YOU DO NOT WORK FOR WILLIAMS MARKETING AND MANAGEMENT, INC AS AN EMPLOYEE. YOU WILL BE RESPONSIBLE TO PAY YOUR OWN TAXES, TRAVEL EXPENSES TO AND FROM WORK LOCATIONS, AND HAVE ACCESS TO, OR OWN A TABLET WITH DATA TO PERFORM THE DUTIES OF THE JOB ASSIGNMENTS.}

_{FURTHER MORE YOU MUST HAVE RELIABLE TRANSPORTATION WITH THE ABLITY TO CARRY ALL PRODUCTS AND OTHER MATERIALS NEEDED FOR WORK.}

_{AS AN INDEPENDANT CONTRACTOR YOU BE TRAINED AND ONCE TRAINED BE LEFT TO DO THE REQUIRED JOBS INDEPENDANTLY.}

_{A MANAGERS ROLE IS TO TRAIN YOU AND ASSIST WHEN NEEDED, BUT THIS DOES NOT INCLUDE TRANSPORTATION FOR WORK, OR SETTING UP TENTS, TABLES, CHAIRS, ECT.}

_{OUR TEAM OF MANAGERS ARE DEDICATED TO ASSISTING IN ALL OTHER AREAS TO ENSURE YOU HAVE THE OPPORTUNITY ALLOWED TO US ALL. WE'LL DO OUR PART, YOU MUST DO YOURS!}

Signature of acknowlegement*

"Independent Contractor" Application Form