Name

Email Address

Address

City

Province

Postal Code

Phone Number

Cell Phone Number

Please specify the opportunity(s) applying for: Please specify the opportunity(s) applying for: Energy Advisor Independant EA Territorial Developer Independant EA House File Modeller Independant QA Specialist

Preferred Work Location Please list the top 4 cities or areas you would like to provide Energy Assessment services.

Do you own a laptop/pc? Do you own a laptop/pc? Yes No

Do you own a sheetfed scanner? Do you own a sheetfed scanner? Yes No

Do you have high speed internet access? Do you have high speed internet access? Yes No

Do you own a smart phone? Do you own a smart phone? Yes No Type: Android Type: iOS

Rate your knowledge of GMail/Other Rate your knowledge of GMail/Other None Beginner Intermediate Advanced

Rate your knowledge of Microsoft Excel Rate your knowledge of Microsoft Excel None Beginner Intermediate Advanced

Rate your knowledge of Microsoft Word Rate your knowledge of Microsoft Word None Beginner Intermediate Advanced

Rate your knowledge of PDF creating software Rate your knowledge of PDF creating software None Beginner Intermediate Advanced

Rate your working knowledge of computers Rate your working knowledge of computers 0-12 months 1-3 years 3+ years

Do you have a valid drivers license? Do you have a valid drivers license? Yes No

Class

Do you have your own transportation? Do you have your own transportation? Yes No

Are you currently a Registered Energy Advisor? Are you currently a Registered Energy Advisor? Yes No Student in training Haven't started training yet

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