Application for Presence on the Homeservicesusa.com Network
Interested in becoming a member on the homeservicesusa.com network? Please complete the
application below. Print and mail it to Xp3 Group, LLC, P.O. Box 23, Haddon Heights, NJ, 08035.
Once received, a Homeservicesusa.com representative will call you within 24 hours to review your
application. Xp3 Group/Home Servicesusa.com reserves the right to accept or decline a participant
to the network. Thank You and we look forwarding to hearing from you.
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Date: ____ ____ _____
Business name:_______________________________
Your name:__________________________________
Address:_________________________ city:_____________________ zip code:_________________
Telephone number: ( ) ___________ - ____________
Email Address:__________________ @ __________________________
Years in business:_____
Your Trade: __________________________________________________________________________
What services do you provide?___________________________________________________________
Insurance(s):__________________________________ none:_________
License # (if applicable):__________________________________________________________
One primary town you provide service to:___________________________________________________
Additional surrounding towns you primarily service:____________________________________________
Are you able to furnish references upon request? __________________________
The information I provided above is accurate and complete.
Print Name:_________________________
Signature: __________________________
Office use: ___ approved ___ declined Membership Period: Start date: End date:
Notes:
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| A Local Home Owner & Contractor Network |
| A Local Delaware Valley Home Improvement Center |
