LCM Agent Application
Thank you for your interest in being an LCM Agent. Please fill out the form below to see if you qualify.
Personal Information
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Cell Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Referred By
Employment Desired
Position Applying For
*
Customer Service / Sales
Management - Requires Experience
Do you have previous experience?
*
Yes
No
Date You Can Start
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Are You Employed Now?
*
Yes
No
May we inquire of your present employer?
*
Yes
No
Please provide name of current employer, position, name of manager, and manager's number.
*
Ever applied to this company before?
*
Yes
No
Where did you apply before?
*
When did you apply before?
*
Work Schedules/Shifts
*
Full Time - Monday through Friday (Weekends Optional): 9:00am - 7:00pm
What State Are You Applying For
*
Please Select
California
Connecticut
Delaware
Georgia
Illinois
Maine
Maryland
Massachusetts
Michigan
New Hampshire
New Jersey
New York
Ohio
Pennsylvania
Rhode Island
Texas
Virginia
Washington DC
What City or Area
*
What Type of Position are You Applying For
*
Independent Positon
Office Position
Education History
Rows
Name & Location of School
Years Attended
Did You Graduate?
Subjects Studied
High School
College
Former Employers (List below last two employers, starting with last one first)
Rows
From (Month & Year)
To (Month & Year)
Company Name
Position
Reason for Leaving
Employer 1
Employer 2
Former Employers Contact Information
Rows
Name
Title
Phone Number
Email
Employer 1 Contact Person
Employer 2 Contact Person
Do you have customer service/sales experience?
*
Yes
No
Do you have management experience?
*
Yes
No
If yes to above, please provide details
*
What is your longest position held and where?
*
Do you have a working smartphone or tablet with cellular service?
*
Yes
No
If hired today, would you be able to start within 3-5 business days?
*
Yes
No
Are you currently able to travel to our headquarters in Wilmington, DE Monday to Friday? Or are you willing to relocate to be able to travel to our headquarters Monday to Friday, if you are hired?
*
Yes
No
How Did You Hear About Us?
*
Indeed.com
Sign
Referral
Other
Provide at Least Two Personal References (not family members)
Rows
Name
Phone Number
Reference 1
Reference 2
Refence 3
Submit
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