Application Questionnaire
Thank you for taking the time to watch the Career Overview Video. Please fill out this application to help us get to know you better.
Legal Name
*
First Name
Last Name
What name do you go by? What do you prefer to be called? (EX: Robert - Rob, Michael - Mike, or maybe you go by your middle name, etc.)
Email Address
*
Best Contact Number
*
Location (City & State)
*
Street Address
Street Address Line 2
State / Province
Postal / Zip Code
Who invited you to watch the video? (Please provide the name of the person who invited you to watch the video.)
*
How did you hear about us?
*
(Referred by a friend/family, Indeed ad, Zip Recruiter ad, Facebook, etc.)
After watching the video, how would you rate your interest on a scale from 1 to 10?
*
Not At All Interested
1
2
3
4
5
6
7
8
9
Extremely Interested!
10
1 is Not At All Interested, 10 is Extremely Interested!
Why did you give this rating?
*
What appeals to you most about a career with our Agency?
*
What are your Core Values (what matters most to you in life)?
*
What has helped you be successful in your career(s)?
*
What are your top priorities in a career? (Select 3-5)
*
Positive company culture
Income potential
Having a fulfilling career
Advancement opportunities
Flexible schedule
Recognition for accomplishments
Advancement opportunities
Being part of a team
Training and ongoing professional development
Work / life balance
Other
If we talked to your current employer, what are 3 things they would say that best describes you?
*
What example(s) can you give that demonstrate your work ethic and motivation?
*
What are some characteristics about yourself that make you a good candidate for a position with us?
*
What are some of your biggest accomplishments? (Things you have acheived in your personal or professional life that you are proud of.)
*
This is a full time position, are there any limitations on your schedule?
*
Yes
No
If yes, please explain:
BACKGROUND INFORMATION: Do you have any criminal history? Traffic offenses and most minor misdemeanors are acceptable. Felonies and any pending court cases may exclude you from obtaining an Insurance License. Please let us know if there is ANYTHING that will come back when we process your background check.
*
Yes
No
If yes, please explain:
Do you have a valid driver's license and a reliable form of transportation?
*
Yes
No
Every state requires an Insurance License to sell insurance. Can you afford the upfront cost of getting licensed now, the cost is approx $200-$300? (Our company has a reimbursement incentive where after you have sold a certain amount of policies, you are reimbursed for the cost, but you would be responsible for it upfront.)
*
Yes
No
The licensing and onboarding process takes 2-4 weeks. It is generally 3-5 weeks from job offer to when you begin training. Does this work for your schedule and timeline?
*
Yes
No
You will need an iPad on a daily basis for this position, do you currently have an iPad? (Can't be an android or other tablet, must be an Apple iPad.)
*
Yes
No
Are there any specific questions you have right now for us?
Upload Resume:
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Submit Questionnaire Now!
Should be Empty: