Contractor Signup Form – Working VersionBy ajboyd96 / June 16, 2025 Contractor Sign-Up Form Join Our Contractor Network – Partner with Revamped Industries 🏢 Business Information Company Name * Business Type * Select Type LLC Corporation Partnership Sole Proprietorship Other Years in Business * Select Years Less than 1 year 1-2 years 3-5 years 6-10 years More than 10 years License Number 👤 Contact Information First Name * Last Name * Email * Phone * 📍 Location & Service Area Business Address * City * State * ZIP Code * Service Radius * Select Service Radius Up to 25 miles 26-50 miles 51-75 miles 76-100 miles More than 100 miles 🔧 Services Offered Select all services you provide: * Kitchen Remodeling Bathroom Remodeling Flooring Installation Roofing Plumbing Electrical HVAC Windows & Doors Siding Painting Landscaping Other 🛡️ Insurance & Certifications General Liability Insurance * Select Option Yes No Bonded * Select Option Yes No 📋 Additional Information Tell us about your experience Team Size * Select Team Size 1 person (just me) 2-5 people 6-10 people 11-25 people More than 25 people Availability * Select Availability Immediate Within 1 week Within 2 weeks Within 1 month Other 🚀 Submit Application