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Become an ICAT Agency


**All Information provided below will remain strictly confidential**
Your Name *
Address 1 (of business) *
Address 2
City *
State * Zip Code *
Phone # * Fax #
Cell #
Email Address *
How did you hear about ICAT Logistics? *
Current Employer *
Position *
May We Contact Your Current Employer? * Yes
No

Work Experience:
Company Position
Dates Duties
Company Position
Dates Duties
Educational Background:
          High School
School/Location Majors
Degrees Years Attended
          College
School/Location Majors
Degrees Years Attended

          Graduate
School/Location Majors
Degrees Years Attended
          Other
School/Location Majors
Degrees Years Attended
Have you ever owned a business? * Yes (Currently)
Yes (In the Past)
No

Have you ever personally declared bankruptcy? Yes
No
Have you ever been a principal in a company that declared bankruptcy? Yes
No
If you answered 'Yes' to 15 or 16, please explain.
Do you have a non-compete or employment agreement currently in effect? Yes
No
If yes, for how long and what are the terms?
Would you agree to providing us with a copy of the agreement? Yes
No
What is the territory you are requesting?
Please explain your logistics management experience.
Breifley Describe your qualifications to own and operate an ICAT Logistics Agency
In your words, what skills and traits characterize a successful business owner?
Why are you interested in owning and operating an ICAT Logistics Agency?
Do you currently control any business in the requested territory? Yes
No
If yes, estimate average monthly revenue.
Will you have a business partner? (If yes, a separate application is required) Yes
No
Who will be in charge of day-to-day management of the business?
Please indicate your computer experience. (Check all that apply) Windows XP
Windows NT
Windows 2000
MS Office
Please advise any other factors we should evaluate as we consider your application.
Verification By checking this box on this application, I am declaring that all information provided by me in this application is true, correct, and complete.

I authorize investigation of all statements contained in this Agency Application as may be necessary in arriving at a relationship decision, including background verification.
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