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Onelife Exam is giving opportunity to medical examiner, phlebotomist or medical
personnel to tied up with our company to become an independent contractor,
whether, you have a direct or without a direct orders from a life insurance agent.
We are also opening the opportunity to every examiner, phlebotomist, medical
personnel and individual contractor to be a part of our nationwide expansion
program and be involve to become a part of our manpower outreach program, if,
you are qualified. And if, we create a good and beneficial relationship, we are in
search of a potential candidate for a managerial position to handle our branches
nationwide.
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Please read and check off the following for registration
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I understand that upon completing this registration form, I am fully aware that I agree to respect and abide
by the conditions of Onelife Exam and all Federal, State and local laws pertaining to the confidentiality of
identifiable medical, personal and any confidential information obtained from their website.
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I understand that by signing-up on the registration form, all information entered herein will be used to
disclose information to authorized Onelife Exam personnel for screening and background check purposes.
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I understand that all medical or any health information I will acquire from life insurance applicant is
confidential and I have no authority to disclosed this information to anyone, except with Onelife Exam, in
order to process client's paramedical examinations and laboratory test. Note: This only applies to a
phlebotomist or a medical examiner employee of Onelife Exam.
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Does not apply to me, I'm not an employee of Onelife Exam
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I also understand that by signing -up on this registration form, does not empower me to act or represent
Onelife Exam to negotiate, make any transaction or agreement in behalf of the company.
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I understand that upon registration and submitting my information, Onelife Exam has the right to verify and
check the information I have provided, they also have the right to approved and disapprove my application
to obtain a Login ID or password to access their website and secured site. I also understand that upon
typing my name on the space provided for my electronic signature, this will serve as the equivalent of my
legal signature. By clicking the submit button, I will be accountable for all representations made at Log In
and for all work done under my Log In ID.
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I understand that this is not a job application, contract or a binding agreement, but solely, for
registration purposes only. By completing the registration process, I'm aware that it does not
guarantee me for any contract or neither obligates Onelife Exam to offer me an employment. My
intention and interest for a possibility of working with Onelife Exam is under their discretion and
approval, if, I would qualify to become an independent contractor. I also understand, that, my
account will be renewable every year and may be subjected for cancellation by the discretion of
Onelife Exam. And by checking the box, I agree with this terms and conditions.
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Address
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Name
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Apt / Ste
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City / State
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Zip Code
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Fax Number
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Cell phone
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SSN
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Driver's License
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State Issued
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Expiration
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Birth Date
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Name of School Last Attended
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Address
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City
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Zip Code
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State
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Degree / Certificate
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Dates Attended
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Specialty / Training
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Date Completed
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Lisensure
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Highest Degree of Education
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Other Language Spoken
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Nationality
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Yrs Completed
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Age
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Language Spoken
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Sex
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Employer
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Address
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Zip Code
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City
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State
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Email Address
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Work Phone
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Ext. No.
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Password Confirmation
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Security Question
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Password
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Applicant's Electronic Signature
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Date Signed / Registered
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If you are interested in joining our team and become an employee of Onelife Exam, you can submit your
application online. Click the link below.
Online Application
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