Desk Adjuster
Pre-Application Form
PERSONAL INFORMATION
Name
*
First Name
Last Name
Primary Email
*
example@example.com
Alternate Email
*
example@example.com
Primary Phone Number
*
Please enter a valid phone number.
Alternate Phone Number
*
Please enter a valid phone number.
Mailing Address
*
Mailing Street Address
Mailing Street Address Line 2
Mailing City
Mailing State
Mailing Zip Code
Physical Address Different Than Mailing Address?
*
Yes
No
Physical Address
*
Physical Street Address
Physical Street Address Line 2
Physical City
Physical State
Physical Zip Code
EXPERIENCE
Desk - Residential - Years of Experience
*
None
1-3 Years
4-7 Years
8-10 Years
10 Years or More
Experience (Multiple Choice)
*
Daily
CAT
Highest Dollar Amount Handled?
*
Highest Authority Amount Allowed?
*
Desk - Commercial - Years of Experience
*
None
1-3 Years
4-7 Years
8-10 Years
10 Years or More
Experience (Multiple Choice)
*
Daily
CAT
Highest Dollar Amount Handled?
*
Highest Authority Amount Allowed?
*
Desk - Large Loss - Years of Experience
*
None
1-3 Years
4-7 Years
8-10 Years
10 Years or More
Experience (Multiple Choice)
*
Daily
CAT
Highest Dollar Amount Handled?
*
Highest Authority Amount Allowed?
*
Do you have Commercial Construction Experience?
*
Yes
No
Highest Level of Commercial Construction Experience?
*
Laborer
Foreman
Supervisor
Estimator
Superintendent
General Contractor
Years of Experience
*
Xactimate/XactAnalysis Experience?
*
Yes
No
Symbility/Claims Connect Experience?
*
Yes
No
REFERENCES
2 Claims Related References Required - Management Level
Reference #1
*
First Name
Last Name
Reference #1 Current Company
*
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Reference #2
*
First Name
Last Name
Reference #2 Current Company
*
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Current Resume - REQUIRED*
*
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If a valid resume is not submitted, you will not be considered.
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DISCLAIMER
Completing this form does not guarantee a deployment with Vector Risk Solutions. All roles and deployments are determined by the needs of our Carrier partners. Please ensure all information was completed to the best of your ability. Thank you for your interest, we look forward to working with you!
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