Utah Adjuster - Claims Adjuster , Adjuster, Insurance

Employment Opportunities

Utah Adjuster has no openings for employment at the present time. Prospective candidates with claims experience can copy and paste their resume on our Contact Page in the appropriate space or complete the application on this page for consideration of positions as they become available.

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APPLICATION FOR EMPLOYMENT

Fields marked with an asterisk (*) are required.

*Position Desired:		*Full or Part Time:
*PERSONAL INFORMATION*
Name: (Last, First, Middle)*		Social Security #:
*Present Address:		How long have you lived there? (Years, Months)*
*Previous Address:		How long did you live there? (Years, Months)*
*Telephone #:		*Are you 18 years of age or older?
*Have you ever worked for this Company before?		If Yes, please give dates and position(s) held:
*Do you have any friends or relatives working here?		If Yes, please give Name(s) and Relationship:
*How would you get to work, if hired?		*Primary E-mail Address:

*Have you ever pled guilty or "no contest" to a crime or been convicted of a crime?
If yes, please give date and details of each:**
**NOTE: Answering "Yes" to this question does not constitute an automatic bar to employment. Only those crimes that are substantially related to the position you are seeking will be considered.

*RECORD OF PREVIOUS EMPLOYMENT*
Please list the names of your present or previous employers in chronological order with present or last employer listed first. Be sure to account for all periods of time including military service and any period of unemployment. If self-employed, give firm name and supply business references. Attach additional copy (in .txt format) below if needed to provide complete information.
*Present or Last Employer:		**Employed From - To: (mo/yr - mo/yr)***
Address: (Street, City, State, Zip)*		Pay: (Start/Final)*
*Telephone:		*Your title or Position and Job Duties:
Reason for Leaving:
Amount of notice provided by you:		*Name and Title of Last Supervisor:

Present or Previous Employer:		Employed From - To: (mo/yr - mo/yr)
Address: (Street, City, State, Zip)		Pay: (Start/Final)
Telephone:		Your title or Position and Job Duties:
Reason for Leaving:
Amount of notice provided by you:		Name and Title of Last Supervisor:

Present or Previous Employer:		Employed From - To: (mo/yr - mo/yr)
Address: (Street, City, State, Zip)		Pay: (Start/Final)
Telephone:		Your title or Position and Job Duties:
Reason for Leaving:
Amount of notice provided by you:		Name and Title of Last Supervisor:

Previous Employer:		Employed From - To: (mo/yr - mo/yr)
Address: (Street, City, State, Zip)		Pay: (Start/Final)
Telephone:		Your title or Position and Job Duties:
Reason for Leaving:
Amount of notice provided by you:		Name and Title of Last Supervisor:

Previous Employer:		Employed From - To: (mo/yr - mo/yr)
Address: (Street, City, State, Zip)		Pay: (Start/Final)
Telephone:		Your title or Position and Job Duties:
Reason for Leaving:
Amount of notice provided by you:		Name and Title of Last Supervisor:

Attach (cut and paste) additional work history here if needed:

*Have you ever been terminated or asked to resign from any job?
If Yes, please explain circumstances in detail:
Please explain fully any gaps in your employment history:
*May we contact your current employer?
If No, please explain:
Please indicate any actual experience that you have which you feel is relevant to the position for which you are applying:

*EDUCATION*
*Elementary School:*
*Name and Address:		*Years Completed:

*High School:*
Name and Address:		Years Completed:
Diploma/Degree Awarded, Certificate Awarded:		Describe Course of Study or Major:
Describe Specialized Training, Experience, Skills, and Extra Curricular Activities:

*College/University:*
Name and Address:		Years Completed:
Diploma/Degree Awarded, Certificate Awarded:		Describe Course of Study or Major:
Describe Specialized Training, Experience, Skills, and Extra Curricular Activities:

*Graduate/Professional:*
Name and Address:		Years Completed:
Diploma/Degree Awarded, Certificate Awarded:		Describe Course of Study or Major:
Describe Specialized Training, Experience, Skills, and Extra Curricular Activities:

*Trade or Correspondence School:*
Name and Address:		Years Completed:
Diploma/Degree Awarded, Certificate Awarded:		Describe Course of Study or Major:
Describe Specialized Training, Experience, Skills, and Extra Curricular Activities:

*Other:*
Name and Address:		Years Completed:
Diploma/Degree Awarded, Certificate Awarded:		Describe Course of Study or Major:
Describe Specialized Training, Experience, Skills, and Extra Curricular Activities:

*EMERGENCY INFORMATION*
In case of an accident or other emergency, whom should we contact?
*Name:		*Relationship:
*Home Address:		*Telephone:
Work Address:		Telephone:
*How did you hear about us?		If referred, by whom?

*PERSONAL REFERENCES*
Please list persons who know you well - not previous employers or relatives:
*Name	*Occupation	Address (Street, City, and State)*	*Telephone Number	*Number of Years Known

THIS APPLICATION WILL BE CONSIDERED ACTIVE FOR A MAXIMUM OF THIRTY (30) DAYS. IF YOU WISH TO BE CONSIDERED FOR EMPLOYMENT AFTER THAT TIME YOU MUST REAPPLY.

WE ARE AN EQUAL OPPORTUNITY EMPLOYER

APPLICANT'S STATEMENT

I understand that if I am hired by Utah Adjuster, (hereinafter "the Company") my employment will be for no definite period, regardless of the period of payment of my wages. I further understand that I have the right to terminate my employment at any time with or without notice, and the Company has the same right. No one other than the President of the Company had authority to modify this relationship or make any agreement to the contrary. Any such modification or agreement must be in writing and signed by the President of the Company.

I understand that the Company reserves the right to require me to submit to a drug test at any time and also reserves the right to require me to submit to an alcohol test and/or medical examination to the extent permitted by law. I authorize the Company to investigate my driving record, my criminal record, my credit history, and education history, and I understand that an investigative consumer report may be prepared whereby information is obtained through personal interviews with neighbors, friends and others with whom I am acquainted. This inquiry would include information as to my character, general reputation, personal characteristics, and mode of living. I understand that I have the right to make a written request within a reasonable period of time to receive additional detailed information about the nature and scope of this investigation.

I further understand that the Company may contact my previous employers and I authorize those employers to disclose to the Company all records and other information pertinent to my employment with them. I also authorize the Company to provide truthful information concerning my employment with it to my future prospective employers and I agree to hold it harmless for providing such information.

I certify that all of the information that I provide on this application and in any interview will be true and accurate. I understand that if I am employed and any such information is later found to be false, incomplete or misleading in any respect, I may be dismissed.

DO NOT SUBMIT UNTIL YOU HAVE READ AND UNDERSTAND THIS STATEMENT

I CERTIFY THAT ALL OF THE INFORMATION THAT I HAVE PROVIDED IN THIS APPLICATION IS TRUE AND ACCURATE.

*Date:	Applicant's Signature: (Type your full name)*

*Email Address:

*By digitally signing (typing your name and email address) this form, you are verifying that all the information you have provided is true, correct, and complete.

Enter Image Security Code: