Fill out info below
Name
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Email
*
example@gmail.com
City & State Where You Live
*
If address is a apartment put apartment #
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Do you currently have health insurance ?
*
No I do not have health insurance
Yes I have health insurance thru my job
Yes I have Medicaid
Yes I have Medicare
Yes I have Ambetter
Yes I have BlueCross BlueShield
Yes I have Cigna
Yes I have UnitedHealthcare
Yes I have Humana
Yes I have Oscar
Yes I have Aetna
Yes I have health insurance but not sure the company name I have it with
Which shift would best fit your schedule ?
*
7am - 3:00pm
3:00 - 11:00pm
Weekends only Saturday and Sunday
I want to work a flexible schedule that I choose the days and hours
Are you open to work weekends if we ever need you to ?
*
Yes I'm open to working weekends
No I can't work weekends
I may be available to work some weekends
I work my job on weekends so I'm not available to work weekends
Do you currently work a job ?
*
Yes I currently work full-time
Yes I currently work part-time
Yes I work for companies DoorDash, UBER, Lyft to earn some extra income
I don't have a job but I do various gigs to earn cash to keep my bills paid
No I am not currently employed with any company
Have you ever worked any type of Work From Home job before ?
*
Yea I have worked from home before
No I haven't worked from home before
If you’re hired do you have a quiet area in your home where you can work to answer and return calls with little to no background noise ?
*
Yes I do have a quiet area in my home
No I don't have a quiet area in my home
No I don't but I'm willing to work on creating a quiet space in my home to talk to customers
Do you have any family or friends who may also be looking for a job working from home ? If so please list all their names and phone numbers below or just type NONE.
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