All items marked with an * are required for registration.

Do you have a Business now, if so, what is the name?:
Is it a Corporation, Partnership or Sole Proprietor?
*What is Your Physical Address?
*Mailing Address if Different than Physical Address:
*In What City are You Located?
*In What State are You Located?
*What is Your Zip or Mail Code?
*In What Country are You Located?
*What is Your Full Name?
*What is Your Position or Title?
*If You're a Licensed Business, What is Your License Number?
What Hours are You Available?
Do You Have a Web Site?	Yes:
*E-mail Address:
*Telephone:
Cell Phone?
Fax::
Below, completely describe what part you would like to play in the development of hometownshopping.com.  Include city, state, or whatever area you wish to do.  If you have a resume, indicate that and e-mail it to us as an attachment, on a separate e-mail with subject line, "resume" and your name.  We don't open attachments without knowing the content and the sender and we must receive this form first before you send the resume.  Tell us about yourself: graphic arts experience, computer experience, if you own your own home, and so on.  We are looking for stable people who are community minded.  We are not interested in people of dubious backgrounds, for obvious reasons. Graphics and computer experience, or the ability to learn very quickly are necessary and very helpful.  Ideally, we are looking for a team: husband and wife or families in each community.  Hometownshopping.com is family and community oriented.  This is a great opportunity for the right people.