IC Registration Form

Independent Contractor Registration

First Name:

Middle Name:

Last Name:

Date of Birth:

Street Address:

Street Address 2: (Apt., Unit. Suite. etc)

City:

State:

Postal / Zip Code:

Email:

Phone:

Role of Interest:

Cleaner

Lead Generator

Sales Representative

Any Prior Experience?

If YES, how much experience do you have?

When are you available to start?

Do you have reliable transportation?

Additional Information:

Proof of Identity: *(valid government or state issued photo ID)

Proof of Identity: *(birth certificate, social security, school transcript, etc.)

Proof of Residency: *(utility bill, bank statement, voter's card, etc.)

Opt-In

By checking, I acknowledge and agree to the following:

Truthfulness & Accuracy I certify that the information I have provided in this application is true, complete, and accurate to the best of my knowledge. I understand that providing any false, misleading, or incomplete information may result in the denial of my application, immediate termination (if already engaged in work), and/or restrictions on future employment opportunities with BLUEDIAMONDs Inc and its subsidiaries. Authorization to Verify Information I authorize BLUEDIAMONDs Inc., its subsidiaries, partners, and designated agents to: Verify any and all information provided in this application Contact employers, references, institutions, or other relevant sources Conduct background checks, identity verification, and eligibility screenings using the personal information I have provided Use of Personal Information I understand that the personal data I provide may be used for hiring, onboarding, verification, and compliance purposes. BLUEDIAMONDs Inc & Subsidiaries may store and process my information consistent with applicable state and federal laws. Background Check Consent I voluntarily authorize BLUEDIAMONDs Inc & Subsidiaries to obtain background screening reports as needed, which may include criminal history, identity validation, employment verification, and other legally permitted checks. Consequences of Falsification I understand that any falsification or omission may result in: Disqualification from the hiring process Immediate termination if work has already begun Restrictions or limitations on eligibility for future roles.

Consent & Agreement By electronical signing below, I confirm that: I agree to share my form responses.

Contractor Signature

Full SSN

$50 OFF 1st Service Request

Independent Contractor Registration