Subcontractor Form
Please fill out the following application to join our Field Services Partner Program
Are you an individual or business subcontractor?
*
Individual
Company
Contractor Type
Field Technician, Including General Onsite IT and Cabling
Journeyman Electrician (High-Voltage)
Licensed Electrician (High-Voltage)
HVAC Technician
Business Name
General Liability Insurance Carrier
Contractors License #
Contact Name
*
First Name
Middle Name
Last Name
Contact Email Address
*
example@example.com
Contact Number
*
Format: (000) 000-0000.
Dispatch Address (Your home or office location)
*
Street Address
Street Address Line 2
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
Can we use the above address to ship your materials and supplies?
Yes
No, use a different address
Shipping Address
Street Address
Street Address Line 2
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
How did you hear about us
Please Select
LinkedIn
Indeed
ZipRecruiter
Craiglist
Event
atompod.com
Other
Referral
Upload Your Resume or Portfolio Background
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
LinkedIn Profile
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Which Phone Number should we use to Dispatch New Requests to you?
Please enter a valid phone number.
Format: (000) 000-0000.
Can we use this phone number to send SMS texts?
Please Select
Yes
No
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.
Format: (000) 000-0000.
Would you like to add second emergency contact?
Yes
No
Emergency Contact #2 Name
Emergency Contact #2 Relationship
Emergency Contact #2 Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
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Dispatch Coverage
Our dispatch team will do their best to keep most work within a one-hour distance from your "dispatch location" or home. However, if you need to travel beyond that distance we will provide additional compensation for your drive time.
Considering the statement above, how far are you willing to travel from your dispatch location for jobs? (miles)
*
Enter a number in miles
What Days and Hours are you willing to take jobs?
Most jobs are M-F Normal Hours, but sometimes to minimize impact, work has to be done when customers are closed. If we ever have overnight projects or weekend work, advanced notice and confirmation will be provided to you. For outside of Normal Hours, we provide a special tier of pay to make it worth your time.
Mondays
*
Normal Hours (8am-6pm)
Late Hours (6pm-12am)
Early Hours (12am-8am)
Not Available
Tuesdays
*
Normal Hours (8am-6pm)
Late Hours (6pm-12am)
Early Hours (12am-8am)
Not Available
Wednesdays
*
Normal Hours (8am-6pm)
Late Hours (6pm-12am)
Early Hours (12am-8am)
Not Available
Thursdays
*
Normal Hours (8am-6pm)
Late Hours (6pm-12am)
Early Hours (12am-8am)
Not Available
Fridays
*
Normal Hours (8am-6pm)
Late Hours (6pm-12am)
Early Hours (12am-8am)
Not Available
Saturdays
*
Normal Hours (8am-6pm)
Late Hours (6pm-12am)
Early Hours (12am-8am)
Not Available
Sundays
*
Normal Hours (8am-6pm)
Late Hours (6pm-12am)
Early Hours (12am-8am)
Not Available
Federal Holidays
*
Normal Hours (8am-6pm)
Late Hours (6pm-12am)
Early Hours (12am-8am)
Not Available
Not Available
Normal Hours (8am-6pm)
Late Hours (6pm-12am)
Early Hours (12am-8am)
Not Available
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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?
Yes
No
Please list any certifications or licenses you hold.
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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
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Smartphone and Laptop
All jobs require that you bring the following equipment. Please answer the following questions about your smartphone and laptop.
Do you have a Smartphone that can take High-Quality Photos and Mobile Data Hotspot Capability?
*
Yes, Android
Yes, Apple
Yes, Other
No
Do you have a Laptop & Charger that you take with you on jobs?
*
Yes, Windows
Yes, Mac OS
No
Do you have a Serial Adapter and Console Cable for your laptop that you take on jobs?
*
Yes
No
Do you have a hands-free headset or earbuds to talk to support while working on sites?
*
Yes
No
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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
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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
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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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W9 and Payment Information
Our accounting team will release payments twice per month for jobs completed in each period. Work is completed upon following check-in and check-out instructions, and submitting deliverables/work orders/photos. Missing deliverables or not following instructions will cause payment delays. Please acknowledge.
Please acknowledge the information about payments above.
*
I Acknowledge
Notes
Contact?
Interested - High
Interested - Med
Interested - Low
Contacted
Screened
Screened - Reconsider Later
Signed On
DNH
Not Reviewed
Set a Competitive Hourly Rate
What is your desired hourly rate for Normal 8am-6pm onsite jobs? Note that this is not guaranteed, and our vendor manager will contact you before sending a contract.
Desired Hourly Rate
*
Please verify that you are human
*
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