(Either copy and paste onto a text e-mail slate , fill out and e-mail to hi-tech@hi-techind.com - or - If you feel more comfortable print out , fill in and fax to 702-878-4959 - please print or type)
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Here are instructions on how to copy and paste:
a. With your mouse, highlight the *entire* page below
b. Select the EDIT menu and choose COPY
c. Go to your e-mail program and *click inside* the window where you normally type an e-mail message
d. Select the EDIT menu and choose PASTE
e. Now hit ENTER on your keyboard to copy the entire page onto your e-mail message slate
f. Address the message to hi-tech@hi-techind.com
g. Fill in the questions and send the e-mail
It's that easy! :-)
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(e-mail as described above or print out, fill out and snail-mail or fax to)

Hi-Tech Industries, Inc.
9418 Irondale Ave.
Chatsworth, Ca. 91311

fax= 702-878-4959

~Confidential Application Form~

 

PERSONAL INFO ....

Name:_________________________________________________________________________

Address:_______________________________________________________________________

City:___________________________________Province/State:_____________ Postal/Zip Code:________

Home Tel. #:___________________________________________________________________

Bus Tel. #:_____________________________________________________________________

e-mail address:_________________________________________________________________

How long at present address?:______________________________________________________
Previous Address:______________________________________________________________
How Long:____________________________________________________________________

Age: _______ Marital Status:____________________# of Dependent Children:________

Spouse's Name:_________________________________________________________________________

 

BUSINESS INFO ...

Occupation:_____________________________________________________________________
Name of Employer:______________________________________________________________________
Business Address:_______________________________________________________________________

City:___________________________________Province/State:_____________ Postal/Zip Code:________

Position and duties:________________________________________________________________________

How long with this firm?:_________________________________________________________________________

(NOTE: YOUR PRESENT EMPLOYER WILL NOT BE CONTACTED WITHOUT YOUR AUTHORIZATION)

(Fill in only If you are Self Employed)

Name of Business:______________________________________________________________________

Address:_______________________________________________________________________

City:___________________________________Province/State:_____________ Postal/Zip Code:________

# of People in Organization ?? Adm. ( ) Sales ( )

Brief description of business:______________________________________________________________________


How Long?: ___________________________________________________________________

GENERAL INFO ...

Have you ever been in business for yourself ? ________________________________________

If "Yes" - what kind of business ?: _________________________________________________

If you went into business for yourself to what degree could you invest ?: $_________________________

Your Own Capital $_____________________________________________________________

Borrowed $____________________________________________________________________

Immediately Available $____________________________________________________________________________

Will you be able to devote the time that is needed to supervise this business ?____________________________________________________________________________

If not, who do you plan to have do it ?____________________________________________________________________________

Do you understand that the success of your business depends upon the efficiency with which you handle your accounts ?_____________________________________________________________________________

If your application is accepted, how soon can you start ?_____________________________________________________________________________


REFERENCES...

Names and Telephone numbers of three character references:

1)-___________________________________________________________________________

2)-___________________________________________________________________________

3)-___________________________________________________________________________


Names and Telephone Numbers of three credit references: (if you are already in business)

1)-___________________________________________________________________________

2)-___________________________________________________________________________

3)-___________________________________________________________________________

I understand that this is NOT a contract, and this form incurs no obligation on either party.
I certify that the above information is complete and correct ...

 

Your Name :_____________________________________________________________________________

Date:__________________________________________________________________________

ADDITIONAL ....

(Please use this space or add extra pages to tell us anything else which you think is relevant, such as family business history, your personal business objectives, tax considerations, outstanding business ventures in which you have participated, etc....)