Recruitment Partner Application

References
Please list references you may have from another institution.
Reference #1
Name
First/Given Name Surname/Family Name
Title
Company or School Name
Phone
(Country Code, City Code, Number)
Email
Reference #2
Name
First/Given Name Surname/Family Name
Title
Company or School Name
Phone
(Country Code, City Code, Number)
Email
Confirmation*
I certify that the information provided above is correct. I understand that 宅男福利社 may terminate its relationship with me, my agency, or any associated representatives for any reason and at any time.
- Yes
Digital Signature*
Title, Name, Date

宅男福利社