New Partner Application Form - Solus  
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  Confidential
 

If you are interested in joining Change as a Partner to sell and deliver our existing products and services, and add to your own, complete the following form.

All information given will be treated with the strictest confidence.

No references will be sort, or employers contacted (if applicable) without your express permission.

We will call you upon receipt of this Application Form to organise a preliminary meeting.
 
 
Basic Information
Name:
 
Address:
Postcode:
     
Contact Information
Home No.
 
Work No.
 
Mobile No:
 
Email:
     
Personal Details
 
Date of Birth:
 
Age:
 
Nationality:
 
Marital Status:
 
No. of Children:
 
Driving Licence:
 
Licence Details:
 
Languages (fluent):
     
Education
 
Secondary School:
 
Dates:
 
Qualifications:
     
 
College:
 
Dates:
 
Qualifications:
     
Professional / Training
 
Professional Memberships:
 
Training Courses/Certificates Attained:
     
Employment History
 
Employer 1:
 
Job Title:
 
Leaving Salary:
 
Dates (to/from):
 
Responsibilities:
 
Achievements:
 
Reason for Leaving:
     
 
Employer 2:
 
Job Title:
 
Leaving Salary:
 
Dates (to/from):
 
Responsibilities:
 
Achievements:
 
Reason for Leaving:
     
 
Employer 3:
 
Job Title:
 
Leaving Salary:
 
Dates (to/from):
 
Responsibilities:
 
Achievements:
 
Reason for Leaving:
     
 
Employer 4:
 
Job Title:
 
Leaving Salary:
 
Dates (to/from):
 
Responsibilities:
 
Achievements:
 
Reason for Leaving:
     
Employment References:
 
One:
 
Two:
 
Three:
     
Business Contacts:
 
Bankers:
 
Accountant:
 
Solicitor:
     
General:
 
On what basis are you looking to join Change Partners:
Sole Partner LLP LTD PLC
 
Will this be your only business interest?:
 
Will you be working on your own or part of a team?: 
 
Will you have any other partners to introduce to change?: 
 
What are you ultimately looking to achieve through this partnership?: 
 
What are your general observations on what you have seen/heard about Change?: 
 
Why do you think you would be an asset to Change?: 
 
Where did you hear about Change?: 

Thank you for your time in completing this application form. Please ensure that the contact numbers/email address are suitable for normal communication.