AOC-Application – Agents of Change Broadcasting Network

AOC-Application

First Name

Middle Name

Last Name

Address

City

State

Zip code

County

Phone Number

Date of Birth

Place of Birth

Single, Married, Divorced

Name of Spouse

Name and Ages of Children

Name of High School – Finished?

College – Place -Major – Year Finished

Grad School – Place – Major – Year Finished

Post Grad – Place – Major – Year Finished

Trade School – Place – Field of Study – Year Finished

Are you doing what you’ve been trained to do?

What kind of work do you do? Please explain in detail

What kind of business do you own? What is the nature of your business?

List all special training, skills and knowledge that can benefit Agents of Change. (administration, organizer, management, clerical, minister, public speaker, teacher, systems creator, people skills, self starter, social media manager, videographer, website manager, audio sound engineer, performing artist, musician, song writer, playwright. And whosoever will. ALL PEOPLE ARE NEEDED!!

Date

Hello!