Professional Information Submission Form Note: Please read the terms and conditions by clicking here before you proceed Personal Information Full Name * Please enter your full name. This field is required. Company Name (if applicable) Please provide your company name if applicable. This field is required. Gender * Please select your gender. Select an option Male Female Other Prefer not to say This field is required. Contact Information Street Address * Enter your street address. This field is required. City * Enter your city. This field is required. State * Enter your state. This field is required. ZIP Code * Enter your ZIP code. This field is required. Phone Number * Enter your phone number. This field is required. Alternate Phone Number (optional) Enter an alternate phone number (optional). This field is required. Email Address * Enter your email address. This field is required. Preferred Method of Contact * Select your preferred method of contact. Phone Email Text This field is required. Professional Information List your skills and the services you offer * e.g., carpentry, plumbing, electrical work. This field is required. Do you have any specializations or areas of expertise? * Yes No This field is required. If yes, please specify Specify any specializations. This field is required. Are you licensed? If yes, please provide details License details. License Type Enter license type. This field is required. License Number Enter license number. This field is required. Issuing Authority Enter issuing authority. This field is required. Do you have any professional certifications? * Yes No This field is required. If yes, please list them Enter certifications you hold. Are you insured? If yes, please provide details Details about your insurance. Insurance Provider Enter insurance provider. This field is required. Policy Number Enter your policy number. This field is required. Coverage Type Enter coverage type. This field is required. Can you provide proof of insurance? * Yes No This field is required. Can you provide DBA (Doing Business As) or LLC paperwork? * Yes No This field is required. Please load proof of insurance, DBA, LLC, make sure it is labeled with your company name Click to upload or drag and drop This field is required. Years Working in the Field * How many years have you been working in your field? This field is required. Briefly describe your work experience * Provide a brief summary of your work experience. This field is required. List your last three jobs and what was done Job 1 - Client Name * Enter the client name for Job 1. This field is required. Job 1 - Location * Enter the location for Job 1. This field is required. Job 1 - Description of Work * Provide a description of the work done for Job 1. This field is required. May we contact this client for a reference? If yes, provide contact details Provide reference contact details. This field is required. Job 2 - Client Name Enter the client name for Job 2. This field is required. Job 2 - Location Enter the location for Job 2. This field is required. Job 2 - Description of Work Provide a description of the work done for Job 2. Job 3 - Client Name Enter the client name for Job 3. This field is required. Job 3 - Location Enter the location for Job 3. This field is required. Job 3 - Description of Work Provide a description of the work done for Job 3. Do you have a portfolio or photos of previous work? * Yes No This field is required. Please upload the photos make sure they are labeled with your company name please. Click to upload or drag and drop This field is required. Do you have your own equipment? * Yes No This field is required. If yes, please list the equipment you have. List any equipment you own. Service Area and Availability Locations you are willing to travel to * List the cities, counties or regions. This field is required. Maximum distance willing to travel (in miles) * Enter the maximum distance you are willing to travel. This field is required. Availability * Please specify your availability. This field is required. Days of the Week Available * Enter the days of the week you are available (e.g., Mon, Tue). This field is required. Hours Available * Please specify your hours of availability (e.g., 8 AM - 5 PM). This field is required. Are there any scheduling constraints we should be aware of? * Yes No This field is required. If yes, please explain Please explain any scheduling constraints. Project Expectations and Requirements Project Expectations and Requirements What are your expectations and needs for the project sites you might work on? Access to utilities (electricity, water, etc.): This field is required. Site preparation requirements: This field is required. Assistance from client (e.g., moving furniture): This field is required. Safety considerations: This field is required. Other needs: This field is required. What are your payment terms and expectations? Hourly Rate or Fixed Price: Payment Schedule (e.g., deposit required, payment upon completion): Preferred Payment Methods: (Cash, Check, Credit Card, Online Payment) Do you offer warranties or guarantees on your work? (Yes/No) * Select an option Yes No This field is required. If yes, please provide details: References References 1 - Name This field is required. Relationship: This field is required. Ref #1 Phone Number: This field is required. Ref # 1 Email Address: This field is required. References 2 - Name This field is required. Relationship: This field is required. Ref #2 Phone Number: This field is required. Ref # 2 Email Address: This field is required. Additional Information Are you willing to undergo a background check? (Yes/No) * Select an option Yes No This field is required. Are you a member of any professional associations? If yes, please list them: Have you ever had any complaints or legal actions taken against you related to your work? (Yes/No) If yes, please list them: Are you a member of any professional associations? If yes, please list them: (e.g., OSHA training, safety courses) Do you have any constraints or special requirements we should be aware of? Please provide any additional information that might be relevant: Consent and Agreements Do you consent to have your information shared with potential clients? (Yes/No) Select an option Yes No Do you agree to adhere to our company's terms and conditions? https://jobs.iamopen.org/terms-and-conditions/ Select an option Yes No When you click on submit below, we will get your information, review the details, do some research and get back with you with in 72 hours. Submit There was an error trying to submit your form. Please try again.
