Please print the following form, complete and mail to:

FaFa Group
23545 Crenshaw Blvd., #101E
Torrance, CA 90505

AE Application Form     廣告業務代表申請表格

 Note: ALL fields must be completed!

Do you work for the United States Government? ___ Yes ___ No; if yes, position: ___________
Do you work for any other Government? ___ Yes ___ No; if yes, name of country: ___________
Have you ever committed any crime: ___ Yes ____ No;  if yes, describe: ___________________
______________________________________________________________________________
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Applicant’s Name: _________________________ (Last) __________________________ (First)
Address: ______________________________________________________________________
              City: ______________________________ State: _________ Zip Code: ____________
Tel: _____________________ Cell: __________________  e-mail: ________________________

I am a: _____ U.S. Citizen, my U.S. Passport number is _______________________________
            _____ U.S. Permanent Resident, my Green Card number is ______________________
            _____ Alien with Work Permit, my Work Permit number is ______________________

My Social Security Number: __________________ My Driver License #: __________________

Name of most recent employer: _________________________ Tel: ______________________
I worked there from ______________ to ________________ as _________________ (Position)
Reason of leaving: ______________________________________________________________

I certify that I am applying for the position of "Account Executive (AE)" at FaFa Group located at 23545 Crenshaw Blvd., #101E, Torrance, CA 90505 (hereinafter "Company") and, if I am hired, I will become an independent contractor (not an employee) of the Company. I will be paid only on commissions from the advertisement orders solicited by me. I understand that I will not be paid any base salary, allowance, reimbursements, or other benefits.

Once hired, I will hold the Company, its officers and employees, harmless from any and all claims, losses, expenses (including attorney’s fees), damages, injuries, causes of action and/or liabilities arising from working as an Account Executive (AE) for the Company. These include but not limited to the claims or suits for libel, plagiarism, invasion of privacy, and copyright infringement.

I further certify that, at any time, the Company can terminate my contract/agreement with a 30-day written notice. Any dispute(s) between the Company and I shall be settled by means of arbitrations or others but litigation. I will never file any lawsuit(s) against the Company, its officers or employees.

I have read and completely understand this application and agree that the Company has the right to examine my documents, make copy(ies) of them, and verify my employment. I further declare under penalties of perjury that the information provided above is true and correct.

Signature: ___________________________ Date: ________________________

If your application is approved, you will receive an ID number from FaFa Group.
如果您的申請獲得批准, 您將得到<發發集團>發給您的識別號碼.