Political Canvassing Application
Thank you for inquiring with Resurgence Brokerage! The following information is required to start your background check/ onboarding process. Please complete the application form to its entirety to avoid any delays. Once selected, you will receive a follow up for onboarding and be scheduled for training.
Email
*
example@example.com
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Date of Birth
*
-
Month
-
Day
Year
Date
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
FULL SSN
*
Clear headshot (no glasses, no hats)The required setting has been lifted to eliminate file size limitations.Please email your photo(s) to Resurgencebrokerage@gmail.com if you have any technical issues with this section.
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Photo ID- Please email your photo(s) to Resurgencebrokerage@gmail.com if you have any technical issues with this section.
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Do you have any felony charges?You are ineligible for this position if ANY felonies are found on your background regardless of the time frame.
*
Please Select
YES
NO
Please select the following state you will work in:
*
Arizona
Michigan
Pennsylvania
Nevada
How did you hear about us?
*
facebook
Instagram
Poster/flyer
Indeed
Submit
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