Set Up Your Name Badge and Credentials Post Type Form 13 Solo Operator or Linked to a Group? Solo Operator (Owner) Part of a Group (Employee)Group Leader FirstGroup Leader LastGroup Leader EmailPreviousNextFirst NameLast NameName to Appear on Your ID BadgeInclude Pronouns on Verify My Records Page He, Him, His, Himself She, Her, Hers, Herself They, Them, Theirs, Themself Ze, Zir, Zirs, Zirself Si, Hir, Hirs, Hirself No Pronouns IncludedCompany Name to Appear on BadgePosition TitleEmailWebsite or Business FB Page (Optional)Company PhoneMailing Address for Your ID BadgeAddress Line 1Apt, Lot, Suite, etc.CityStateZip CodeCountrySelect CountryAfghanistanAland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelauBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicDemocratic Republic of the Congo (Kinshasa)DenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyIvory CoastJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacao S.A.R., ChinaMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalestinian TerritoryPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRepublic of the Congo (Brazzaville)ReunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint Martin (Dutch part)Saint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia/Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited Kingdom (UK)United States (US)United States (US) Minor Outlying IslandsUnited States (US) Virgin IslandsUruguayUzbekistanVanuatuVaticanVenezuelaVietnamWallis and FutunaWestern SaharaYemenZambiaZimbabweService Area Where You Work (Your mailing address will not be shown)PreviousNextType of Work (example: House Cleaning, Carpet Cleaning, Landscaping)Â (Google Snippet) SEO: In the box below describe you and your work for the search engines in one sentence.ex: Janice Waldron is the owner/operator of Waldron Cleaning Services in Canton, OH specializing in general house cleaning and maid service. This sentence works REALLY WELL. You can copy and paste it in the box and change the red part to make it about you and your business.Google SnippetLearn about the right size for documents to upload. NOTE: All of these documents are included with your annual Verify My Records membership at no extra charge.) COI: Your actual COI will be kept on file with us and verified by our team. Only your renewal date will show to the public.Which Documents Are You Uploading Today? (Click on each item to activate) ID Badge Photo Company Logo COI: Certificate of Insurance No Uploads TodayPassport Photo for ID BadgeUpload Photo (head and shoulders only) png or jpeg Person in this PhotoUpload Company Logo (Optional)Upload Logo png or jpeg Include your logo on the Verify My Records Website linking back to your website? (SEO Backlink) Yes NoWhat website do you want us to link back to?Certificate of Insurance (COI)Upload COI png or jpeg Website of your insurance branch so we can verify this Google the name of your insurance company. Copy the URL of the branch that sold you your policy. That URL goes in this box. Insurance Renewal DatePreviousNext I consent to have this website store my submitted information so they can verify my records. I hereby certify that the above statements and documents submitted are true and accurate to the best of my knowledge. Previous Verify My Records
