Name

Email

Address

City, State, Zip

Phone () Fax () S.S. Number

Questions:

1. Where did you hear about this position?

2. How many hours per week can you work? Can you work daytime hours?

3. Do you have a fax machine or computer with fax software? Describe.

4. Why do you want to work from home?

5. How much money do you want to make per week? Per hour?

6. Rate your understanding of the Internet. Very Familiar Learning Not Familiar at All

7. When are you able to start work?

8. List your 3 strongest attributes.

9. Would you consider yourself as an introvert or extrovert?
How well do you work without supervision? Describe.

10. Describe your work / phone experience.

11. What long distance phone service are you using and your per minute rate.

12. How would you rate yourself as a customer service person?

Please Provide 3 References: (2 Business 1 Personal)

Name	Phone	Relationship
1.
2.
3.