Are you registering as a company or an individual?

First Name

Last Name

Email Address

Phone Number

Date of Birth

Street Address

City

State

ZIP Code

Willing to Travel? Yes No

Preferred Work Radius (miles)

Years of Experience None 1-2 3-5 5+

Equipment Experience Pallet Jack Forklift Wrap Gun

Able to lift 50+ lbs? Yes No

Available Start Date

Available Days Monday Tuesday Wednesday Thursday Friday Saturday Sunday

Preferred Shifts Morning Afternoon Evening Overnight

Bank Name

Routing Number

Account Number

Password

Confirm Password

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