Application Form | American Freedom Insurance Company

Upload Resume
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Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Email*
Referral Source*
Highest Level of Eduation:*
Position Applying For:*
Date you can start:*
MM slash DD slash YYYY
Desired Salary:*
Have you ever applied to this company before?

References
List 3 professional references that are not related or just a personal friend to you.
Reference 1
Reference 1:Name (First & Last)*
Reference 1: Phone*
Reference 1: Business*
Reference 1: Years Known:*
Reference 1: Relationship to this person:*
Reference 2
Reference 2: Name (First & Last)
Reference 2: Phone
Reference 2: Business:
Reference 2: Years Known:
Reference 2: Relationship to this person:
Reference 3
Reference 3: Name (First & Last)
Reference 3: Phone
Reference 3: Business:
Reference 3: Years Known:
Reference 3: Relationship to this person:

Saturday Work
Name*
Saturday Work: I understand that this position may require that I work on Saturday, which may include every Saturday. I agree that I can and will work every Saturday that I am assigned to work, regardless of whether other staff work on Saturday or not and whether or not my initial schedule includes Saturday hours.
First Last
Describe why you would like to work for this company and why you should be hired.*

ARE YOU PREVENTED FROM LAWFULLY BECOMING EMPLOYED IN THIS COUNTRY BECAUSE OF VISA OR IMMIGRATION STATUS?*
Are you a U.S. Citizen?*
Are you legally able to work in the U.S.?*
Are you 18 years or older?*
Have you ever had a criminal conviction? If yes, Please explain.
"I CERTIFY THAT ALL THE INFORMATION SUBMITTED BY ME ON THIS APPLICATION IS TRUE AND COMPLETE, AND I UNDERSTAND THAT IF ANY FALSE INFORMATION, OMISSIONS, OR MISREPRESENTATIONS ARE DISCOVERED, MY APPLICATION MAY BE REJECTED AND, IF I AM EMPLOYED. MY EMPLOYMENT MAY BE TERMINATED AT ANY TIME.IN CONSIDERATION OF MY EMPLOYMENT, I AGREE TO CONFORM TO THE COMPANY'S RULES AND REGULATIONS, AND I AGREE THAT MY EMPLOYMENT AND COMPENSATION CAN BE TERMINATED, WITH OR WITHOUT CAUSE. AND WITH OR WITHOUT NOTICE, AT ANY TIME, AT EITHER MY OR THE COMPANY'S OPTION. I ALSO UNDERSTAND AND AGREE THAT THE TERMS AND CONDITIONS OF MY EMPLOYMENT MAY BE CHANGED, WITH OR WITHOUT CAUSE, AND WITH OR WITHOUT NOTICE, AT ANY TIME BY THE COMPANY. I UNDERSTAND THAT NO COMPANY REPRESENTATIVE, OTHER THAN IT'S PRESIDENT, AND THEN ONLY WHEN IN WRONG AND SIGNED BY THE PRESIDENT, HAS ANY AUTHORITY TO ENTER INTO ANY AGREEMENT FOR EMPLOYMENT FOR ANY SPECIFIC PERIOD OF TIME, OR TO MAKE ANY AGREEMENT CONTRARY TO THE FOREGOING."
Name:*
First Last
Date*
MM slash DD slash YYYY