Awakened Innovations-Service Provider Application
The purpose of this form is to collect information from service providers interested in participating in Awakened Innovations to provide high-quality services to not-for-profit companies. Please fill this out as fully as possible. We will be verifying information to the extent possible.
Email address *
*
Your answer
Last Name *
Your answer
Position *
Your answer
Phone number *
Your answer
Company Name *
Your answer
Is your business a CERTIFIED MBE or WBE? *
Company Website *
Your answer
If you have one, what is your company's tagline?
Your answer
BBB Link (if you have one) *
Your answer
Any additional validation of your work and the quality of your work. Testimonials, review pages, etc.
Your answer
Services you would like to provide through this platform (title, list price, not-for-profit price) *
Your answer
Do you currently already have a referral-type program where you compensate people who send you referrals? What terms do you currently provide? *
Your answer
Will you be able to provide testimonials attesting to the quality of your work? *
For vetting purposes. Reference #1. A previous customer who can speak to the quality of your work. Please provide: Name, company name, title, email, phone number. *
Your answer
For vetting purposes. Reference #2: A previous customer who can speak to the quality of your work. Please provide: Name, company name, title, email, phone number. *
Your answer
Any additional information you would like to provide.
Your answer
I understand that this agreement is as an independent contractor. No employment, partnership, or joint venture is implied or established. *
Required
I understand this is an offer to be listed in a database of service providers. No guarantee is made regarding the number or other characteristics of potential clients presented. *
Required
I agree that I, or the company I represent, will provide work in line with expectations of my industry. If the customer has an issue with services provided, I agree to work in good faith to arrive at a mutually agreed upon resolution. Awakened Innovations may, at its sole discretion, participate to resolve such issues. *
Required
I understand this is a commercial arrangement and agree to pay any agreed upon fees to Awakened Innovation. These will be agreed upon before-hand in writing or by electronic communication. *
Required
I agree that any liability that arises from my work will be my sole responsibility and will not be the responsibility of Awakened Innovations. *
Are you interested in referrals to for-profit companies?
Would you like to be notified of news related to Awakened Innovations through our mailing list and other avenues?
Copyright @2018, Awakened Innovations, Inc – All Rights Reserved
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google.