Become a Handyman ApplicationHow did you hear about us ?PhoneEmailWebTrade ShowFlyerAdvertisementReferralHomeclub MemberHomeclub PROPersonal InformationApplicant Name* First Last Email* Phone*Date of Birth* Personal Information Cont'dAddress Line 1* Address Line 2 Address Line 3 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Employer InformationWho are you currently working for:* I work for myself I work for a company Your Business or Employer Name Name of Business or Employer Methods for receiving dispatch informationCheck all that applies: Email Dispatch IPhone Android Check the services that you can provideAssembly Barbeque grill Furniture (indoor or outdoor) Play set / Swing set Shelving & Storage Trampoline Installation A/C - filter Appliances Bathroom hardware (rods/bars/holders) Circuit breaker Dishwasher Doors Drain line (kitchen/bathroom) Exhaust Fan Faucet Garage remote programming Garbage disposal Gutter/downspout (up to 20') HVAC thermostat Light bulb (up to 20') Light fixture (up to 20') Light switch Locks (interior/exterior doors) Mailbox/Post Outlet Picture hanging (up to 20') Range hoods Siding & exterior trim Sinks Tiles Toilets TV Installation Window blinds/curtain Window glass Window hardware Window screen Window shutter (up to 20') Window trim Maintenance A/C filter Basic clogged drain clearing Caulking (door/window) Door lock/hardware replacement Garage remote programming Gutter cleaning (up to 20') Light bulb replacement Smoke detector/battery replacement Trash removal (to your curb) Water heater (relight pilot) Weather stripping Window shutter (rehang/replace) Repair Ceiling Door Door trim Drain line (under sink) Drywall (repair & paint) Grout/Mortar Gutter/downspout (up to 20') Hose bib (exterior water supply) Interior/Exterior trim Interior water supply lines Light fixture Light switch/outlet Mailbox/Post Shelving (wood/wire) Siding Sink Shower tub fixture Tile Toilet tank fill valve Toilet wax ring/hardware Water leak (bath/kitchen) Weather stripping Window hardware Wood deck Wood fence Wood porch Service Area*I am willing to travelI prefer a limited travel areaHomeclub may service members in various cities and counties throughout your metro area. For you to become a Service Pro, you must be willing to travel to these areas. You must be able to provide service to our members on an on-call basis and within 60 minutes of an appointment.Electronic W-9 Request for Taxpayer Identification Number and Certification (W-9) As you know, Homeclub, LLC. will need your W-9 information for federal tax reporting. Information sent from this website is encrypted and you can securely provide your W-9 electronically using the form below. However, if you are an individual (not a business) and prefer not to submit your SSN electronically, you can manually complete a W-9 Form and fax it to 888-394-4098. Click here for a W-9 Form Tax ClassificationCheck Box For Tax Classification Info:*Individual / Sole ProprietorCorporationPartnershipOtherOther DescriptionPart - I Taxpayer Identification Number (TIN) If this is corporation, LLC or other business entity, please provide your federal Employer Identification Number (EIN). If this is an individual and not a business, please provide your Social Security Number (SSN). Employee Identification Number (EIN)Social Security Number (SSN)*Part - II Certification Under penalties of perjury, I certify that: The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and I am not subject to backup withholding because : (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding, and I am a U.S. person (including a US resident alien). Electronic Signature (type your name)*InsuranceHomeclub requires the following license & insurance coverage: Valid Driver’s License Auto Insurance: $100,000 / occurrence min Note: General Liability insurance coverage of $1,000,000 will be provided to all Pros.Auto Insurance Carrier NameAuto Insurance Carrier PhoneAuto Certificate of InsuranceWe must have a copy of your current auto certificate of insurance to maintain on file. If you have an electronic copy of your auto insurance certificate, please upload the file below: Upload Certificate of Insurance Drop files here or If you do not have an electronic copy, please fax a copy. Fax : 888-394-4098 Terms and Conditions of this AgreementI have read this agreement carefully* Agree IN WITNESS WHERE OF, Consent is given by the applicant for a background check to be obtained by the Company. It is, however, understood that the applicant supplies this information contained herein to the best of his/her knowledge and ability and that the company relies on this fact in evaluating the applicant’s qualifications. This Agreement has been executed by the applicant as of the date accepted and executed by Homeclub as set forth below. Electronic Signature (type your name)*Date* Any special instructions or message that we should know? This iframe contains the logic required to handle Ajax powered Gravity Forms.