🔒 Private & secure

Candidate portal

Candidate Submission

Complete the questions below and attach the requested files. The form is optimized for phones and tablets.

Only the questions that apply to you will appear. You can preview and remove files before submitting.

Application progressRequired fields completed as you go.

Candidate Information

Complete the fields that apply to you.

Full Legal Name *

Phone Number

Email Address

Full Address

Last 4 Digits of SSN

Enter only the last 4 digits.

Mother's Maiden Name

This question is independent and can be moved anywhere from the admin dashboard.

Work Authorization

Complete the fields that apply to you.

Is the candidate a U.S. Citizen? *

Yes No

E-Verify Complete? *

Yes No

Authorization Type *

Other Authorization

Authorization Expiration Date

Prior Work — Frontier

Complete the fields that apply to you.

Worked for Frontier before? *

Yes No

Last Date of Service *

Old Badge Available? *

Yes No

Old CRIS #

Old Corp #

Prior Work — CCI

Complete the fields that apply to you.

Worked for CCI before? *

Yes No

Prior Work — Brightspeed

Complete the fields that apply to you.

Worked for Brightspeed before? *

Yes No

Market Previously Worked *

Manager's Name *

Last Date of Service *

Availability

Complete the fields that apply to you.

Cell Phone Provider

Available to Start In-Market On

Certification & Notes

Complete the fields that apply to you.

Certification Name

Certification Date

Notes

Supporting files

Upload, preview, and remove files before sending.

Headshot *

Current JPEG/PNG headshot.

Up to 1

＋

Choose files