Nobility Distinction Brand Application 2021
P.O. Box 485, Smyrna, GA 30081 Office: 404.824.2554 www.NDBLLC.com
Full Name
*
Prefix
First Name
Last Name
Suffix
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Home Phone Number
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Area Code
Phone Number
Cell Phone Number
*
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Area Code
Phone Number
E-mail
*
Birth Date
*
Please select a month
January
February
March
April
May
June
July
August
September
October
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Month
Please select a day
1
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30
31
Day
Please select a year
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
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1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Year
Are you a U.S. Citizen?
*
Yes
No
If NO, are you authorized to work in the U.S.?
Yes
No
Have you ever worked for this company?
*
Yes
No
If YES, what were your dates of service? Ex: From December 1, 2015 - December 1, 2016
Have you ever been convicted of a felony?
*
Yes
No
If YES, explain
Do you own a personal computer with Windows 7 or Windows 8?
*
Yes
No
Are you proficient in any languages other than English?
*
Yes
No
If YES, please list the language(s) and level of proficiency.
Referred By:
Military Service
Have you ever served in the military?
*
Yes
No
If so, what branch?
If so, what were your Dates of Service?
Were you discharged?
Yes
No
If so, what type?
Certification & Signature
I certify that my answers are true and complete to the best of my knowledge. If this application leads to a sub-contractor position, I understand that false or misleading information may result in my immediate release.
Date
*
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Month
-
Day
Year
Date Picker Icon
Printed Name
Signature (hold down the left-click on your mouse to sign or initial the forms)
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Back
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Terms & Conditions
Please INITIAL to show your agreement with the following statements
1) I understand I will be paid by direct deposit on the 15th and the last day of each calendar month, unless those dates fall on a weekend and/or holiday, in which case it will be the business day before.
*
2) I understand that Nobility Distinction Brand, LLC will not deduct taxes from my check. I will receive a 1099 at the end January of the following year and understand I will be responsible for filing taxes.
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3) I am aware that Nobility Distinction Brand, LLC will withhold an administrative fee from each paycheck in the amount of $19.75 (subject to change), which is paid to directly Arise.
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4) I understand that if I choose not to give 30-day notice should I choose to leave Nobility Distinction Brand, LLC. it will be at their discretion on when to release/drop me.
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5) I understand once I certify with a client, I will be issued a Statement of Work (SOW) by Arise. I understand this must be signed and returned to Nobility Distinction Brand, LLC before I begin servicing the client in which I have certified to service.
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6) I understand Nobility Distinction Brand, LLC and/or Arise have the right to terminate my SOW and/or Contract at any time.
*
7) I understand the revenue may vary from agent-to-agent or client-to-client.
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8) I am aware that I am not promised a job. This is to verify my information and qualifications for a possible position when an opportunity that I am qualified for is available.
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9) I am aware that I will be a sub-contractor under Nobility Distinction Brand, LLC, who sub-contracts with Arise and depending on the opportunity that I choose, I may be paid by the hour, by talked minute, or by the call, which will be determined by Nobility Distinction Brand, LLC.
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10) I understand there is no guarantee of a set hourly pay if I choose an opportunity paid by the talked minute or by the call.
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11) I understand that some opportunities offer incentives and/or some may offer commission, which I will be paid for based upon my SOW.
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12) I understand I should carry my own liability insurance. If I choose not to carry liability insurance, I hold Nobility Distinction Brand, LLC harmless of any claims or lawsuits due to conduct/negligence of clients, Arise, or any other sub-contractor.
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13) I understand being a CSP that we do not contact our clients (whom we service) directly, as it is a violation of Arise policy and could result in termination and/or further legal action.
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Confirmation of Terms & Conditions
I certify that my answers are true and complete to the best of my knowledge. If this application leads to a sub-contractor position, I understand that false or misleading information may result in my immediate release. I agree to the previously stated terms & conditions.
Date
*
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Month
-
Day
Year
Date Picker Icon
Printed Name
Signature
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