VoiceLog®

1. First Name:
2. Middle Initial:
3. Last Name:

1. I verify that I am at least 18 years old and legally permitted to work in the United States.

1. I agree to and understand that VoiceLog may at some point in time, verify all information that is provided during the Live Operator Application process and that the independent contractor role is contingent upon the successful completion of a criminal and credit background check if such a check is deemed necessary by VoiceLog or BSG Clearing Solutions.

1. CONTACT YOU DURING THE DAYTIME?*

   1. Yes
   2. No
2. CONTACT YOU DURING THE EVENING?*

   1. Yes
   2. No
3. 1. Best time of the day to reach you?:*
   2. Street Address:
   3. City:*
   4. State:* select Alabama Alaska American Samoa Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Federated States Of Micronesia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Palau Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming
   5. ZIP:*
   6. Country:* Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua And Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia And Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Congo, The Democratic Republic Of The Cook Islands Costa Rica Cote D Ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Heard Island And Mcdonald Islands Holy See (Vatican City State) Honduras Hong Kong Hungary Iceland India Indonesia Iran, Islamic Republic Of Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakstan Kenya Kiribati Korea Democratic Peoples Republic Of Korea Republic Of Kuwait Kyrgyzstan Lao Peoples Democratic Republic Latvia Lebanon Lesotho Liberia Libyan Arab Jamahiriya Liechtenstein Lithuania Luxembourg Macau Macedonia, The Former Yugoslav Republic Of Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia, Federated States Of Moldova, Republic Of Monaco Mongolia Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Palestinian Territory, Occupied Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saint Helena Saint Kitts And Nevis Saint Lucia Saint Pierre And Miquelon Saint Vincent And The Grenadines Samoa San Marino Sao Tome And Principe Saudi Arabia Senegal Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia And The South Sandwich Islands Spain Sri Lanka Sudan Suriname Svalbard And Jan Mayen Swaziland Sweden Switzerland Syrian Arab Republic Taiwan, Province Of China Tajikistan Tanzania, United Republic Of Thailand Togo Tokelau Tonga Trinidad And Tobago Tunisia Turkey Turkmenistan Turks And Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Venezuela Viet Nam Virgin Islands, British Virgin Islands, U.S. Wallis And Futuna Western Sahara Yemen Yugoslavia Zambia Zimbabwe
   7. Daytimes Phone:*ex: (123) 123-1234
   8. Evening Phone:*ex: (123) 123-1234
   9. E-Mail Address:*ex: yourname@domain.com

I verify that I have met the following phone requirements:

1. High Speed Internet Service*

   1. Cable
   2. DSL
   3. Service Provider Name:
2. Dedicated 2nd Telephone Line*

   1. Already Installed
   2. Ordered but not installed
   3. Install Date:
3. Call Waiting*

   1. Yes
   2. No
4. FAX MACHINE*

   1. Yes
   2. No
5. CALL FORWARDING*

   1. Yes
   2. No
6. HEADSET*

   1. Yes
   2. No

7. I verify that I have met the following computer requirements:

8. Computer Brand*

   1. Computer Brand:
   2. I verify my computer is not an Apple or E-Machine
9. MEMORY*

   1. 512 MB RAM
   2. 1 GB RAM or more
10. 1. CPU (processor) Type:* select amd intel other
    2. Free Disk Space:*
    3. Operating System:* select Windows 2000 Windows XP Windows Vista
    4. Internet Browser:* select IE 6.0 IE 7.0 IE 8.0 Mozilla Firefox Safari
    5. Email Provider:*
11. ABLE TO ACCEPT LARGE ZIP FILES*

    1. Yes
    2. No
12. AOL INSTANT MESSENGER*

    1. Set up
    2. Not set up
13. PRINTER SET UP AND WORKING CORRECTLY*

    1. Yes
    2. No
14. ANTI-VIRUS SOFTWARE INSTALLED*

    1. Yes
    2. No
15. SPYWARE OR ADAWARE SOFTWARE INSTALLED*

    1. Yes
    2. No

16. I verify that I have the following office environment requirements:

17. QUIET WORKSPACE*

    1. Yes
    2. No
18. PETS TO DISTRACT DURING SCHEDULED SHIFTS*

    (i.e. barking dogs)

    1. Yes
    2. No
19. CHILDREN IN OFFICE DURING SCHEDULED SHIFTS*

    1. Yes
    2. No

1. HOW DID YOU HEAR ABOUT VOICELOG?*

   1. Online Job Posting
   2. Online Bulleting Board
   3. Online Chat Room
   4. Current or previous VoiceLog Operator (Name)
   5. Other (explain)
2. HIGHEST LEVEL OF EDUCATION YOU HAVE COMPLETED?*

   1. High School or GED
   2. Some College
   3. AA Degree
   4. College Graduate
   5. Technical Degree or Certificate
3. PREVIOUSLY WORKED IN A CALL CENTER ENVIRONMENT?*

   1. Yes
   2. No
   3. If yes, with what company?:
4. TYPES OF CALLS HANDLED*

   1. Outbound
   2. Inbound
   3. None
5. What Timeframes Are You Available To Work?*

   (minimum 4 hours)

   1. Monday:
   2. Tuesday:
   3. Wednesday:
   4. Thursday:
   5. Friday:
   6. Saturday:
   7. Sunday:
6. Are you willing to work other time frames?*

   1. Yes
   2. No

1. DO YOU SPEAK SPANISH?*

   1. Yes, I can speak Spanish fluently
   2. I am able to speak a little Spanish
   3. No, I don't speak Spanish
2. DO YOU SPEAK ENGLISH?*

   1. Yes, I can speak English fluently
   2. I am able to speak a little English
   3. No, I don't speak English
3. DO YOU READ AND WRITE ENGLISH?*

   1. Yes, I can read and write English fluently
   2. I am able to read and understand a little English
   3. No, I am not able to read and write English
4. Do you speak, read and write any other languages?: