Independent Sales Agent On-Boarding Form

Independent Sales Agent On-Boarding Form

Please complete this form truthfully and send the signed Agreement to admin@alchemi.tech
Your Name *

First Name Last Name
Your Personal Email *
example@example.com
What is your Birth Date? *

Month Day Year
Phone Number *

Area Code Phone Number
Your Address *

Street Address

Street Address Line 2

City

Postal / Zip Code Country
Below is the Alchemi Independent Sales Agent Agreeement. Please download, read & sign it. Send a signed copy to admin@alchemi.tech
Please upload a picture or copy of your Passport or Government ID (Only PNG. or JPG. files accepted) *
Please download the Discord App on your phone.

We exclusivley use the Alchemi Discord App for all communications with our community of sales agents. To register, we strongly suggest you download the APP onto your phone for effortless communication with our team. Download from here: https://discord.com/new
Should be Empty:

Please download the Discord App on your phone.