Daiwa Systems
1099 Independent Contractor
Rad ID: Please copy and paste this link if you do not have a Rad ID
Representative Accountability Database (RAD)Universal Service Administrative Companyhttps://www.usac.org › lifeline › rad
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
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Social Security Number
*
RAD ID:
*
DOB:
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Month
-
Day
Year
Date
Telegram:
*
Discord:
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Do you Prefer
*
Door to Door Sales
Field Sales
Both
Have you been convicted of a felony?
*
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Within 7 Years
Over 7 Years
Never
Do you have manager experience?
*
Please Select
Yes
No
If you do have manager experience; how many years of experience?
Please Select
1 year
2 years
3 years
4+ Years
Address
*
Street Address
Street Address Line 2
City
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Postal / Zip Code
Photo ID & Headshot:
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Signature
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Date
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