Application for Dealership for Powrachute Product Line

Date: ____________________

Instructions:

Review Distributor Territory Map to see if you are eligible to become a Powrachute dealer for Easy Flight, Inc.

Then, print this form out on your printer, complete it, and mail to Easy Flight, Inc., PO Box 38, Greenville, IL 62246
Personal Information
 

____________________________

Last Name

  

_________________

Middle Name

  

_________________

First Name

  

___________________

Social Security Number
 

______________________________

Street Address

  

________________

City

  

______

State

  

________________

Zip Code
 

_________________________

Phone

  

Yes ______ No _____

Are you at least 18 years old?

  

Yes ______ No _____

If not, do you have a work permit?
Dealership Desired
 

_________________________________________________________________________________________

Description of Area (Normal area is approximately 60 miles around a base office or field, attach a map if appropriate)
 

_________________

Date Available

  

___________________________

What Prompted Your Application?
Yes ______ No _____

Have you ever applied here before?

 _______________ 

If yes, give a date

 Yes ______ No _____

Can you, after employment, submit verification of your identity and legal right to work in the United States?
  Yes ______ No _____

Have you ever been convicted of a felony? (Do not include convictions that have been sealed, expunged, or statutorily eradicated.)

  

If you are not a citizen, what is your visa status?
Education and Training (Dealership Application for: _________________________)
High School
College/University
College/University
Name:      
Location:      
Date Attended From:      
Date Attended To:      
Major:      
Degree:      
Date of Degree:      
 

 

 

 

 

_____________________________________________________________________________

List other job related training, scholastic honors, and vocational and/or professional information.
Skills and Background

List any skills, aptitudes, or educational experience you have which you feel could qualify you for a dealership. Especially any pilot training, sky diving, recreational, marketing, or business skills.

 

 

 

 

 

 

 

 

 

 

 
Experience (Dealership Application for: _________________________)
Present or Most Recent Employer
Previous Employer
Previous Employer
Company:      
Address:

 

 

      
Supervisor's Name:      
Supervisor's Phone:      
May We Contact?      
Your Job Title:      
Date Employed From:      
Date Employed To:      
Starting Salary:      
Ending Salary:      
Reason for Leaving      
References
Reference 1
Reference 2
Reference 3
Name:      
Address:

 

 

      
Phone:      
Relationship:      
 

 

_______________________________________________________

Signature of Applicant

  

 

______________________________

Date