ConnectionsPlanet.com

Zip Code Managers Application

If you are interested in becoming a Zip Code Manager, please complete the form below and click submit.

Last Name:
First Name:
Gender:	Male Female
Age:	under 18 18 and over
Street Address:
City:
State:
Zip:
Area Code & Phone Number:	-
Date of birth (for verification purposes: (dd/mm):	(example: for October 30 enter 10/30, for December 1st, us 12/01.)
Email address:
Why do you want to be a Zip Code Manager?
Have you read the ZCM Rules and do you agree to follow them?	yes no
Will you accept this position as an independent contractor?	Yes No
Do you have any conflicts that would interfer with you serving as a ZCM?	yes no If yes, please explain here
Will you maintain residence in the zip code site you will be managing?	yes no
Do you have any questions you would like answered before acepting this position?