FSP Application Form

Subcontractor Form

Please fill out the following application to join our Field Services Partner Program
Are you an individual or business subcontractor?*

IndividualCompany
Contractor Type

Field Technician, Including General Onsite IT and CablingJourneyman Electrician (High-Voltage)Licensed Electrician (High-Voltage)HVAC Technician
Business Name
General Liability Insurance Carrier
Contractors License #
Contact Name*

First NameMiddle NameLast Name
Contact Email Address*
example@example.com
Contact Number*
Dispatch Address (Your home or office location)*

Street Address

Street Address Line 2

CityState

Zip Code
Can we use the above address to ship your materials and supplies?

YesNo, use a different address
Shipping Address

Street Address

Street Address Line 2

CityState

Zip Code
How did you hear about us
Upload Your Resume or Portfolio Background*

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LinkedIn Profile

Which Phone Number should we use to Dispatch New Requests to you?
Please enter a valid phone number.
Can we use this phone number to send SMS texts?
Which email address can we use to Dispatch New Requests to you?
example@example.com
Emergency Contacts

In the event of an injury or medical emergency, who may we contact?
Emergency Contact #1 Name
Emergency Contact #1 Relationship
Emergency Contact #1 Phone Number
Please enter a valid phone number.
Would you like to add second emergency contact?

YesNo
Emergency Contact #2 Name
Emergency Contact #2 Relationship
Emergency Contact #2 Phone Number
Please enter a valid phone number.

Skills and Certifications

Please complete the following questionnaire about your skills/experience, so that we can appropriately assign work to you.
Terminating Voice and Data Cables*
66-Blocks Telephony Cross-Connects and Feeder Cable*
Basic Troubleshooting of Phone Systems*
Phone Buttset Use - Dial Tone*
Security Camera Installation and Repair*
Fiber Optic Termination and Splicing*
Installing and Mouting Network Rack Systems
HVAC - Low-Voltage Wiring Systems
Electrical Monitoring - Low-Voltage Wiring Systems
Access Control/Security/Fire - Low-Voltage Wiring Systems*
Using a Multimeter to Troubleshoot*
High-Voltage Electrical Wiring and Installation (must be an Electrician)
Installing and Troubleshooting Wireless Access Points*
Troubleshooting Network Switches, Routers and Gateways*
Basic Networking (Familiarity with DHCP & IP Addressing)*
Advanced Network Programming of Switches and Routers *
Troubleshooting Network Switches, Routers and Gateways
Music Overhead Speakers and Wiring - 70v and below*
Using a Scissor Lift*
Using a Boom Lift
POS Point of Sale Troubleshooting and Installs*
Windows PC Troubleshooting
Mac OS Troubleshooting
Linux Troubleshooting
Do you have any Licenses or Industry Certifications to add?

YesNo
Please list any certifications or licenses you hold.

Tools and Equipment

Please select from the following the tools that you currently own, and whether you bring with you everyday, stored at the office/home, or will purchase
OSHA Approved Hardhat
OSHA Approved Safety Vest
OSHA Approved Eye Protection
Flashlight or Headlamp*
A-Frame Ladder 6-Foot or Above*
A-Frame Ladder 8-Foot or Above
A-Frame Ladder 6-Foot or Above
A-Frame Ladder 10-Foot or Above*
Extension Ladder 12-Foot or Above
Extension Ladder 16-Foot or Above*
Extension Ladder 20-Foot or Above
Studfinder and Level
Measuring Tape - 25 Feet or Longer
Phillips and Flathead Screwdrivers
Small Precision Screwdrivers
50' Rigid Fish Tape*
100' Rigid Fish Tape
Cable Pulling Fiberglass Rods
Drywall Saw
Carbide or Better Drill Bits*
Cordless Power and Impact Drills with Charger*
Adjustable Open End Wrenches
Security Torx Driver Bits
Ratchet Wrench and Sockets - Metric and Imperial *
Safety Pylon Cones

Technician's Tools

Please select from the following the tools that you currently own, and whether you bring with you everyday, stored at the office/home, or will purchase
66/110 Punch Down Tool *
Coaxial Cable Stripper and Crimper
RJ-11/RJ-45 Modular Crimper Tool*
Telecom / Electrician's Scissors
Wirecutters and Strippers
Soldering Kit
Telephone Butt Set*
Fluke or Similar Tone Generator and Probe Kit*
Network Tester (Wiremap)*
Network Tester (Length)
Network Tester (Save Results as PDF)
CCTV Camera Monitor/Tester
Electrical Multi-Meter*
Brother P-Touch Labeler or Similar*
Fiber Optic Termination Tools*
Fiber Optic Power Meter
Fiber Optic Visual Fault Locator

Supplies and Materials

Please answer the following questions about your supply and material stock on hand
Box CAT5e - Min of 250' at all times
Box CAT6 - Min of 250' at all times
CAT5e Patch Cables 3' and 7' - Min of 5 at all times
CAT6 Patch Cables 3' and 7' - Min of 5 at all times
RJ-45 Jacks - Min of 10 at all times
RJ-45 Modular Tips/Connectors - Min of 10 at all times
RJ-11 Modular Tips/Connectors - Min of 10 at all times
Surface Mount Boxes - 1 or 2 port - Min of 5 at all times
Faceplates for Jacks - 1 or 2 port - Min of 5 at all times
Packing Tape
Microfiber Cleaning Cloths
Alcohol Wipes
Glass Cleaner
Alcohol Wipes
Electrical Tape
Compressed Air
Pull String
Black Sharpies

Dress Code

Our customers require a professional dress code at all times. Only SOLID COLORS with NO LOGOS (other than Atompod).
Solid Color polos, button ups or sweaters without logos (except Atompod) are acceptable as shown above. Jeans or slacks must be clean and free from tears. Please acknowledge.*

I Acknowledge
Badge Photo
A Badge with your photo will be created for use if you visit customer sites. Please upload a clear photo without headwear (unless for religious purposes) using the example above.*

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Emergency Contacts