Smooth Transitions
License Application

 

Name:_____________________________________________________________________________

Address: __________________________________________________________________________

City/State/Zip: ______________________________________________________________________

Phone: ___________________________________________________________________________

Fax: _____________________________________________________________________________

Email Address: _____________________________________________________________________

Age Range: ________20-29, __________30-39, __________40-49, __________50-59, __________60+

Education: _________________________________________________________________________

Work Experience: ____________________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

Work/Experience related to seniors: _____________________________________________________

__________________________________________________________________________________

Reasons for wanting to be a senior move manager: __________________________________________

___________________________________________________________

Things you like to do best: _____________________________________________________________

Things you like to do least: _____________________________________________________________

General geographical area you wish to serve: _______________________________________________

Personal Strengths: ___________________________________________________________________

Personal Weaknesses: _________________________________________________________________

Personal/Professional goals: _____________________________________________________________

___________________________________________________________________________________

Organizations you belong to: ____________________________________________________________

___________________________________________________________________________________


I attest that the information I have provided is correct to the best of my knowledge.
The undersigned authorized Smooth Transitions, LLC, to make such inquiries by an independent
agency to verify character, reputation and criminal history.


Signed: ___________________________________________________________


(Print Name) _______________________________________________________


Mail to:
Smooth transitions
601 Briar Hill Road
Louisville, KY 40206-3011