Onboarding - Defy Mobile

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STAND UP Onboarding Form

Enrollment form for onboarding agents for ETC Stand UP Wireless.

Onboard for Stand Up Wireless

Marketing or Leader Team Name:(Required)

Supervisor Full Name:(Required)

Agent Name(Required)

First Last

Agent Address(Required)

Street Address Address Line 2 City State ZIP Code

Use the resident address of the agent.

Agent's Email Address(Required)

Email Address Confirm Email Address

Agent Phone #(Required)

Agent's RAD ID(Required)

Representative Accountibility Database (RAD) is a registration system that validates the identities of service provider representatives performing transactions in the NLAD and the National Verifier. Does this agent already have a RAD ID?

Shirt Size(Required)

Agent Date of Birth(Required)

Agent Last 4 of Social Security #(Required)

Photo ID Image:(Required)

Max. file size: 256 MB.

Photo ID must be issued by the US Government and unexpired. ID images in the form of photocopies, scans, screenshots, "selfies", etc. are NOT acceptable. Must show 4 corners of image and not be BLURRY.

Enrollment State(Required)

What state or states will the agent work in? Note: the state must border the main state.