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Become a Partner – Sub-Contractor Application Form

Thank you for your interest in partnering with Legacy Personnel Inc. as a Sub-Contractor. Please complete the form below. Our team will review your application and contact you if your services align with our current needs.

Company Information

Primary Contact Information

Business Details

Industries Served: (Check all that apply or lists)

Healthcare: Required

Compliance & Credentials

Do you carry the following? (Select all that apply) Required
Select State(s): Required
Are your employees/contractors legally authorized to work?
Is your business in Good Standing with your state Secretary of State? If so, will you be able to provide a Good Standing Certificate when it will be required?
Do you conduct background checks and/or drug screenings where required?
Do you have The Joint Commission (TJC) Certificate?
Do you have a Minority Certificate?

Experience & References

Business References (Up to two related to your experience)

Reference 1

Reference 2

Additional Information

Agreement & Acknowledgment

By submitting this form, you certify that the information provided is accurate and complete to the best of your knowledge. Submission of this application does not guarantee approval or partnership

Thanks for submitting! Our Compliance Officer will review your application and reach out regarding next steps.

Legacy Personnel, Inc.

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