DukingSoft, LLC., USA

iVerify Authorized Agent Application Form

Use this form to apply as an iVerify Authorized Agent. As an Agent, your primary responsibility is to market iVerify Mobile ID system to applicable institutions, companies, and organizations. Amaka Technologies Ltd., in cooperation with its Partner, DukingSoft, LLC., USA, will provide you with all the necessary materials and support. You'll earn a flat amount for each customer that you sign on. Also, you'll perpetually earn a flat amount for each iVerify Mobile ID generated for any of the customers that you signed on. For more information, listen to the audio below; and also, visit amakatech.com and iverifycode.com


Personal Information
Surname:
First Name:
Middle Name:
Residential Address:Street Address:

City:

State:

(If not Nigeria)Enter State/Province:

Zip/Postal Code:

Country:

Phone Number(s):
Email Address:
Date of Birth:
Gender: Female Male
Education
Name/Address of SchoolDegree/DiplomaGraduation Date
Skills and Qualifications: Licenses, Skills, Training, Awards
Employment History
Present or Last Employment
Employer:
Address:
Phone Number(s):
Position/Title:
From/To:
Responsibilties:
Reason for Leaving:
Supervisor:
Previous Employment
Employer:
Address:
Phone Number(s):
Position/Title:
From/To:
Responsibilties:
Reason for Leaving:
Supervisor:
Emergency Contact
Full Name
Phone Number(s):
Relationship:
Personal Referees
Referee 1
Full Name
Phone Number(s):
Relationship:
Referee 2
Full Name
Phone Number(s):
Relationship:
Passport-sized Photo
Attach passport-sized photo:

   
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Amaka Technologies Ltd.