JOB OPPORTUNITY: Details about opening your own online store with Meridian Media Group

1. MERIDIAN MEDIA GROUP ONLINE STORE
Licensee Pre-Qualifications Worksheet
Meridian is looking for qualified people who are interested in a no cost opportunity to operate their own on-line store
selling Meridian’s products. We know that the key to our success is partnering with the right skills, values and
motivation. There is no limit to the income you can make and the only cost to you is your time.
This worksheet is submitted to Meridian for their sole consideration to approve or decline the applicant to become a
CardzStore Licensee. The information provided herein is true and shall be held in the strictest confidence by
Meridian. Agreed YES NO
You have read the attached License Agreement and agree to all the terms and conditions if Meridian approves your
application? YES NO
You understand that Meridian will conduct a background check on its applicants and reserves the right to decline this
application. Meridian will keep confidential any findings from the background check. YES NO
PRE-QUALIFYING QUESTIONS
Please fill out the pre-qualifying questions. This position requires an internet savvy individual. After completing the pre-qualifying
questions if you feel you meet these requirements, continue on to other sections. If you do not, the position is most likely not for yo u.
Do you have a PayPal account? YES NO PayPal Email:
Have you ever sold anything online via EBay or similar sites? YES NO
Explain:
Have you ever built your own website? YES NO
Explain or give Domain(s):
On a scale of 1 to 5 (5 highest), how would you rate your on-line/internet skills?
Have you ever sent out an email blast? YES NO
On average, how many hours are you on-line each day?
Do you have your own blog? Face book, Etc? YES NO
Explain:
What is the average number of hours per day you would plan to work towards
sales for your on-line store?
How much money to you expect to earn per month?
What do you think will be the most effective traffic drivers to your on-line store?
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2. MERIDIAN MEDIA GROUP ONLINE STORE
Licensee Application
LICENSEE INFORMATION
Last Name First M.I. Date
Street Address Apartment/Unit #
City State ZIP
Phone E-mail Address
Date Available Social Security No.
Are you a citizen of the United States? YES NO If no, are you authorized to work in the U.S.? YES NO
Have you ever been convicted of a felony? YES NO If yes, explain
EDUCATION
High School Address
From To Did you graduate? YES NO Degree
College Address
From To Did you graduate? YES NO Degree
Other Address
From To Did you graduate? YES NO Degree
REFERENCES
Please list three professional references.
Full Name Relationship
Company Phone ( )
Address
Full Name Relationship
Company Phone ( )
Address
Full Name Relationship
Company Phone ( )
Address
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3. MERIDIAN MEDIA GROUP ONLINE STORE
Licensee Application, Continued
PREVIOUS EMPLOYMENT
Company Phone ( )
Address Supervisor
Job Title Starting Salary $ Ending Salary $
Responsibilities
From To Reason for Leaving
May we contact your previous supervisor for a reference? YES NO
Company Phone ( )
Address Supervisor
Job Title Starting Salary $ Ending Salary $
Responsibilities
From To Reason for Leaving
May we contact your previous supervisor for a reference? YES NO
Company Phone ( )
Address Supervisor
Job Title Starting Salary $ Ending Salary $
Responsibilities
From To Reason for Leaving
May we contact your previous supervisor for a reference? YES NO
Applicant confirms by the signature all responses in the application are true.
________________________________________ ________________
Applicant Signature Date
INTERNAL USE ONLY
Approved Declined Date
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