Application For Products Agent (For Natural Persons)

Please fill out the following form carefully and send it after making sure the entered information. This form will be checked by working the related to agents department, and the Pars Data will be contact with you, if you reach the necessary conditions.
It is force to fill out the options which are marked with * .

Products Agent Application Form

Type of Request
Full Name*	(.){2,}(\s)+(.){2,}This field is required.
Birth Date	This field is required.Example: 14/01/2011
ID Number	^-{0,1}\d+$This field is required.
National Code*	^-{0,1}\d+$This field is required.10-digit code (without dashes), Example: 0323537854
Education
Work Experience
Experience in the computer (hardware, software)	I have had I haven't had
Province	This field is required.
City	This field is required.
Phone*	^-{0,1}\d+$This field is required.Example: 982188888888
Phone (2)	^-{0,1}\d+$This field is required.Example: 982188888888
Mobile	^-{0,1}\d+$This field is required.Example: 989147777777
Mobile (2)	^-{0,1}\d+$This field is required.Example: 989147777777
Email*	This field is required.Example: arash@yahoo.com
Description (If Necessary)	This field is required.
	Please enter a security code.