Applicant Questionnaire
Your Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State
Zip Code
Email
*
example@example.com
Best Phone Number
*
On a scale of 1-10 (DO NOT USE 7), 1 being not in the slightest and 10 being this is my dream career, where do you rate yourself?
*
1
2
3
4
5
6
7
8
9
10
Not At All Interested
Extremely Interested
1 is Not At All Interested, 10 is Extremely Interested
What appeals to you the most about our career opportunity? Explain Why?
*
Based on what you have done in the past, what gives you confidence you would do well with us?
*
Why do you feel you would be a good fit with our High Performance Sales Cutlure?
*
Are there any limitations on the schedule you would be able to work?
*
YES
NO
If Yes, Please Explain:
There are occasions when travel is important in our business (initial training, company meetings, etc.) Do you have any limitations on possible travel needed for our business?
*
YES
NO
If Yes, Please Explain:
Each state requires a license to sell insurance. The cost is typically $250-$350. We offer a reimbursement incentive; however, you are responsible for the cost up front. Can you afford the cost of getting licensed?
*
YES
NO
Do you have a valid driver's license and a reliable vehicle that is your own? (You do not share that vehicle with someone else)
*
YES
NO
Everyone must pass a background check. While traffic offenses and most misdemeanors are okay, certain types of misdemeanors and felonies will prevent you from being licensed and appointed. Do you have any criminal history?
*
YES
NO
If Yes, Please Explain:
Who contacted you about this position?
*
Name
Submit
Should be Empty: