EmailMe Form - iContact Contest Application

Personal Information

Name *

First Last

Address *

Street Address City State / Province / Region Postal / Zip Code Country / Region

Phone Number *

### - ### - ####

Email

Please list the urls of your current online businesses or blogs here:

If selected, how many hours per week will you be able to contribute to your home business? *

My current employment situation is: *

Full time employment, looking to change careers and/or become self-employed.

Part-time employment looking to supplement and/or replace my current income.

Unemployed, looking to become self-employed.

Self-employed, looking for an additional stream of revenue.

Educational History

Name of School - Degree/Diploma - Graduation Date *

Work Experience

Please provide a list of work experience from most recent to least recent for the last 5 years. *

Is your family supportive of you decision to run your own email marketing business? *

Yes

No

I have not discussed it with them yet.

Do you have any prior experience in email marketing or newsletter creation? *

I have some experience working with iContact or another email marketing program.

I have a good amount of experience and I consider myself an expert in this field.

I don't have any experience.

If selected, you will be expected to appear on This Little Parent Stayed Home several times to share your progress. Have you had any experience talking speaking in front of large groups of people? *

Yes

No

If yes, please elaborate on TV, radio or other public appearances: *

Tell us a story about a time when you overcame a challenge. *

Why do you think you would make an ideal candidate for this program? *

If selected, you may be required to seek your own clients. Please tell us your ideas for how you plan on approaching new business: *

Please tell us about your family. List your spouse, you kids and their ages. *

What kind of writing experience do you have? *

If you were to be selected, how would this business opportunity benefit you and your family? *

Please select your level of technological expertise. With 10 being the highest level and 1 being the lowest: *

Please check all the applications that you have some experience with: *

Summary of Qualities * Please summarize any additional information necessary to describe your qualifications for this position. *

Is there anything else you would like for us to know about you?

How did you hear about this contest? *

I certify that information contained in this application is true and complete. I understand that false information may be grounds for forfeiting the contest prize. I authorize the verification of any or all information listed above.