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MediaRing's IDD Agent Program - Signup Form

Interested To Be A Agent Program?

Please fill in this form and a member of our sales team will contact you shortly.

Those field with * is required.

Personal Particulars
Name * :
Gender* : Male Female
Age* :
Contact* :

Home
    Mobile
    Pager
    Office
Email * :

Present Job
Job Title* :
Industry :
    Others

Prior Experience

Do you have any sales experience?
Yes No   if yes, please specify the no. of years
 
Have you ever been employed by any telecommunication company or appointed as a reseller or agent of any telecommunication services?
Yes No   if yes, please specify the no. of years
 
Are you currently working as an agent?
Yes No   if yes, please specify
Full-Time Part-Time
 
From which industry would you expect your potential customers to come from?

Please specify Industry

Others
 
Thank you for taking the time to complete this questionnaire


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