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Please answer the following questions.
Yes NoAre you legally eligible to earn income in the United States? (If considered, verification will be required by law.)
Yes NoAre you 18 years of age or older? (consideration subject to minimum legal age verification.)
Yes NoHave you ever been convicted of a crime (excluding misdemeanors and traffic offenses)?
If yes, list convictions >
Yes NoAre you capable of performing in a reasonable manner the physical activities involved to demonstrate or deliver Electric Mobility products?
Yes NoIf you answered NO to the question above, do you have an individual to assist you in the physical activities necessary to demonstrate or deliver Electric Mobility products?
Indicate special qualifications or skills:

Please show that you have read and understood the following statements by clicking the Yes radiobox.
You'll need to drive to appointments we set for you.
Although the company has leads in all areas, the average representative travels a minimum of 50-100 miles from home. If you live in a rural area, your weekly travel will probably be more extensive. To avoid any misunderstanding, please acknowledge.
We want to train you to be successful.
I understand that there is a comprehensive but easy to learn sales presentation that can take weeks of study to perfect. If I believe I am suited, I am prepared to follow a proven winning sales presentation that can do nothing but make me a financial success.
Yes No
We want to know why you will succeed.
Our experience has proven that anyone can achieve instant success if they follow our program and have natural sales ability. But there is a big difference between wanting to succeed...and succeeding. Why will you succeed as an Electric Mobility Independent Contracted Sales Representative, and what makes you succeed right now? What are your goals and your burning desires?
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OUR DISCLAIMER
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Rascal Scooters and Powerchairs by Electric Mobility
1-800-662-4548 (1-800-MOBILITY)
Call us anytime with questions or comments
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Electric Mobility Corporation,   One Mobility Plaza,   P.O. Box 156,   Sewell, NJ 08080