Personal Information:
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| Name |
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| E-mail |
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| Address |
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| City |
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| State |
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| Zip Code |
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| Home Phone |
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| Cell Phone |
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| Other |
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Payment Information:
If you do not have a "business name," please enter your
name. All payments will be made via PayPal.
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| Business Name | |
Tax ID (do not enter here. A W9 will be requested if you are hired.)
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| Address | |
| PayPal E-mail |
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Counties you are applying to collect data in:
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| Profile Information: |
| Typing Speed |
wpm |
| Data Entry Speed |
ksph (if known) |
(Leave these boxes blank.)
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-
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| Do you have... (yes / no) |
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| Laptop computer |
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| Laptop battery life when fully charged |
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| PC/desktop computer |
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| Dictation Equipment |
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| Transcription Equipment |
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| Dial-up Internet Access |
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| DSL Internet Access |
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| Cable/Satellite Internet Access |
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| Microsoft Word |
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| Microsoft Excel |
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| Microsoft Works |
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Other Equipment:
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I will: |
| (a) input records directly on laptop. |
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| (b) dictate information into a recorder and
transcribe/input on home computer. |
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| (c) collect data manually and input on home
computer. |
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| Earning range I would feel comfortable with* |
| $
per hour
to $
per hour |
| *Your pay is per record, so your
answer will not affect your actual earnings. This just lets us know whether
your expectations appear to be reasonable in light of your skills, equipment,
and what assignments we have available. Let us know what you need to make
your first week, knowing you'll get faster in order to stay with this assignment
long-term, as well as what you'd like to make, if possible. |
| |
| Number of hours I would be available to work
each week at this assignment: |
| Minimum |
| Maximum |
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| |
| What other research companies have you
worked for in the past or present? Please give details--dates, responsibilities,
etc. |
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| Please share any other information you
feel might be helpful to our working relationship. |
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| Please Initial: |
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| I understand that I am an independent contractor and responsible
for my own expenses and taxes.
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| I agree to collect the assigned data for SunLark
Research in an efficient and consistent manner. If at any time I cannot meet
weekly commitment, either temporarily or permanently, I will notify SunLark
Research immediately.
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| I understand that I must submit an itemized invoice
and status report on a weekly basis to SunLark Research, or I will not be paid.
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| I agree to keep all information in relation to
SunLark Research and/or their processes, etc. confidential.
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| I understand that failure to adhere to these requirements
can be cause for withdrawl of any research work assigned. |
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SIGNATURE / DISCLAIMER:
I, the undersigned, hereby certify that by affixing my name below I have
accurately completed, and attest that all information included with this
application is true and accurate: |
| Court Researcher |
|
| Today's Date |
(mm/dd/yyyy) |
