Independent Contractor Application

Independent Courier/Notary Contractor Application

Provide your contact details, service preferences, availability, and required credentials to apply.
Applicant Information
Full Legal Name

First NameMiddle NameLast Name
Email Address
example@example.com
Mobile Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Home Address / Operating Base

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Service Selection and Availability
Which service(s) do you want to cover?
How would you like to receive opportunities?
Preferred On-Demand Availability Windows
Courier Section
Driver's License Number
Driver's License State
Vehicle Year, Make, & Model
Vehicle Type
Proof of Valid Driver's License

Cancelof
Proof of Auto Insurance

Cancelof
Notary Section
Ohio Notary Commission Number
Commission Expiration Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
E&O Insurance Coverage Amount
Upload Proof of Notary Commission Certificate

Cancelof
Technology and Agreement
Smartphone Check
By checking the box below, I authorize Gaylord Farms LLC to obtain background reports (including criminal history and driving record checks) to evaluate my eligibility to perform independent contractor services.
Background Check Consent
Contractor Acknowledgment
Applicant Signature
Date Signed

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty:

Independent Courier/Notary Contractor Application