*Required Field

First Name:*
Last Name:*
Home Phone:* (ex. 123-456-7890)
Cell Phone: (ex. 123-456-7890)
Email Address:*
Address 1:*
Address 2:
City*
State*
Zip Code*
Franchise Code (if known):
Country*
Degree(s):
Area of Expertise?
Certified?* Yes   No
Please List Certification(s):
Please Describe Prior Technical Experience:*
Please Desribe Prior Sales Experience:
Resume (Optional. Copy and Paste Your Resume in Text Format.):
Do you have materials to work with? Yes   No
Are you willing to display a Fast-Teks Pro sign on your car for a monthly fee? Yes   No
How did you hear about us?*

Technical Proficiencies
Computer Repair and Upgrades Data Back-Up and Recovery Hardware and Software Sales
Managed IT Services Networking and Security Server Support
Software Support Technical Assessments Technology Consulting
Web Development
Other

Days/Hours Available to Take Clients

Select up to three start/end intervals for each day of the week for which you are available. For example, you can select both Monday Start 9am -> End 10am, and Monday Start 3pm -> End 5pm, if you are free for both time periods.

Monday:
 



 
Tuesday:
 



 
Wednesday:
 



 
Thursday:
 



 
Friday:
 



 
Saturday:
 



 
Sunday: