Intervive Communications |Qwest Business Partner| Local, Long Distance, Data

Welcome to the Intervive Communications sub-agent application. We're glad you've taken the time to apply to parter with us. You can apply for this opportunity on behalf of your company or as an individual. Please select the appropriate application below.

If you're accepted as a Intervive Communications agent, you'll become partnered with a dynamic group of professionals. We're eager to learn more about your particular capabilities. Please take your time to fill out the application below. Items with a * by them are required, but to speed the process along, please fill out as much as you can.

Individual Sub-Agent Application

Referral Number Information
Please list the referral number, if any, that you received from an Intervive Sub-Agent Manager:
Primary Point of Contact
Name *
Email *		Phone *
		Fax
Address *
City *	State * Zip *

Employment History
Current/Previous Employer Name
Position Name
Years Worked There
Describe your primary Responsibilities while working there.

Previous Employer Name
Position Name
Years Worked There
Describe your primary Responsibilities while working there.

Previous Employer Name
Position Name
Years Worked There
Describe your primary Responsibilities while working there.

Other Information
Are you eligible to work in the US? *	Yes No
Are you over the age of 18? *	Yes No
Describe your telecommunications sales experience. *
Describe any pertinent education you have received or certificates you possess in relationship to this opportunity.
What other agent programs do you currently participate in?
Please tell us how you came across this opportunity.	Please type the name of the job site, classified, or other.

Company Wide Sub-Agent Application

Referral Number Information
Please list the referral number, if any, that you received from an Intervive Sub-Agent Manager:
Primary Point of Contact
Name *		Title
Email *		Phone *
		Fax
Address *
City *	State * Zip *

Company Information
Company Name *
Address *	(If the same, type same)
City *	State * ZIP
Years in Business
# of Employees
Annual Revenue
Website
Describe the Company's Primary Business

Agent Information
Who should be listed as the sub-agent? *	Individual or Company
Describe you or your business' telecom experience. *
What other agent programs do you currently participate in?
Please tell us how you came accross this opportunity.	Please type the name of the job site, classified, or other.