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Join Our Team
Interested candidates, please fill out the form below.
Employment Application
Application for Employment at Trustpoint Insurance
Equal Employment Opportunity Statement:
Employment decisions will be based on the principles of equal opportunity. All personnel actions (recruiting, hiring, training, promotion, compensation, etc.) are administered without regard to any characteristic protected by state, federal or local law, assuming said characteristic does not interfere with the performance of essential job functions. Reasonable accommodations will be made for disabilities and religious beliefs. Please inform us of any necessary accommodations to the application process.
Applicant Name and Contact Information
Name
*
First
Middle
Last
Address
*
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Phone
*
Email
*
Have you ever gone by a name(s) other than the one listed above?
*
Yes
No
List name(s)
*
General Information / Expectations
How did you learn about Trustpoint?
*
Advertisement
Employee Referral
Employment Agency
Other
Specify
*
What advertisement, which employee, which recruiter or describe other.
Have you ever applied or been employed with us before?
*
Yes - Applied
Yes - Employed
No
Are you currently employed?
*
Yes
No
When did previous employment end?
*
MM slash DD slash YYYY
What was your previous position?
*
When was your previous application made?
*
MM slash DD slash YYYY
When are you available to start work?
*
MM slash DD slash YYYY
Available Status
*
Full TIme
Part Time
Seasonal
Can you travel for work if necessary?
*
Yes
No
Are you over 18 years of age?
*
Yes
No
Are you legally permitted to work in the United States?
*
Yes
No
NOTE: Proof off eligibility will be required at the time of employment.
Are you willing to take a company drug test?
*
Yes
No
Education
What is the highest level of education completed?
*
High School Diploma
Some College
College Degree
Graduate Degree
None of the Above
Name of High School
*
Location of High School
*
High School GPA
*
Name of College
*
Location of College
*
College GPA
*
What was your degree/major?
*
How many years did you attend college?
Name of Graduate School
*
Location of Graduate School
*
Graduate School GPA
*
What was your graduate degree/major?
*
Describe your education background.
*
Do you have any insurance licenses?
*
Yes
No
What insurance licenses do you have?
*
Property and Casualty
Life and Health
Claims Adjuster
Surplus Lines
Other
Check all that apply.
Do you have any insurance designations?
*
Yes
No
Such as CPCU, CIC, CISR, ACSR etc.
Specify designations
*
Any other training, licenses or designations you would like us to know about?
Employment History
How many former employers do you have?
*
Please enter a number greater than or equal to
1
.
If you have more than 4 please upload a separate list.
1. Current Employer Name
*
1. Current Supervisor Name
*
1. Current Employer Address
*
1. Current Employer Phone
*
1. Current Position Title and Duties
*
1. Most Recent Employer Name
*
1. Most Recent Supervisor Name
*
1. Most Recent Employer Address
*
1. Most Recent Employer Phone
*
1. Most Recent Position Title and Duties
*
1. Start Date
*
MM slash DD slash YYYY
1. End Date
*
MM slash DD slash YYYY
1. Starting Pay
1. Ending Pay
1. Why did you leave this job?
*
1. May we contact this employer?
*
Yes - Now
Yes - Later
No
2. Previous Employer Name
*
2. Previous Supervisor Name
*
2. Previous Employer Address
*
2. Previous Employer Phone
*
2. Previous Position Title and Duties
*
2. Start Date
*
MM slash DD slash YYYY
2. End Date
*
MM slash DD slash YYYY
2. Starting Pay
2. Ending Pay
2. Why did you leave this job?
*
2. May we contact this employer?
*
Yes
No
3. Previous Employer Name
*
3. Previous Supervisor Name
*
3. Previous Employer Address
*
3. Previous Employer Phone
*
3. Previous Position Title and Duties
*
3. Start Date
*
MM slash DD slash YYYY
3. End Date
*
MM slash DD slash YYYY
3. Starting Pay
3. Why did you leave this job?
*
3. May we contact this employer?
*
Yes
No
4. Previous Employer Name
*
4. Previous Supervisor Name
*
4. Previous Position Title and Duties
*
4. Previous Employer Address
*
4. Previous Employer Phone
*
4. Start Date
*
MM slash DD slash YYYY
4. End Date
*
MM slash DD slash YYYY
4. Ending Pay
4. Starting Pay
4. Ending Pay
4. Why did you leave this job?
*
4. May we contact this employer?
*
Yes
No
Personal References
1. Reference Name
*
1. Reference Phone
*
1. Years Known
*
Please enter a number greater than or equal to
1
.
2. Reference Name
*
2. Reference Phone
*
2. Years Known
*
Please enter a number greater than or equal to
1
.
3. Reference Name
*
3. Reference Phone
*
3. Years Known
*
Please enter a number greater than or equal to
1
.
Upload Documents
You indicated more than 4 previous employers. Please upload a list of those employers with Name, Supervisor Name, Phone Number, Date Started, Date Ended, Starting Salary, Ending Salary, Reason Left and if we can contact them.
Upload Documents
If you have any documents that you would like to attach as part of your application (such as a resume) you may do so here.
Drop files here or
Select files
Max. file size: 50 MB.
Applicant's Statement
Upon submitting this electronic application:
I certify that the information provided in this application is true, to the best of my knowledge.
I understand that providing false or misleading information at any time during the application and interview process may lead to refusal to hire or discharge from the Company. If I become employed by Trustpoint Insurance, I agree to follow all rules and regulations of the Company as they develop and change.
I allow the Company to conduct investigations on me, my background and my performance, and am aware that such investigations will become a part of my employment record. With this, I authorize the Company to speak with my acquaintances, personal and professional, to gather information about me.
I authorize all former employers and references to provide any information about me to the Company, and release them of liabilities and damages of all kinds for providing this information. I authorize the Company to verify the accuracy of the information within this application. I also authorize the release of my educational transcripts to the Company for education verification purposes.
I release from liability for collecting information about me and using it to make employment decisions.
If I become employed by the Company, I understand that the employment relationship will be “at will,” and that the “at will” status may not change at any time unless specifically approved, in writing, by the President of the Company.
I agree that if I become indebted to the Company, I will be responsible for repaying the total owed upon termination from the Company. If I do not repay the sum prior to my final paycheck being received, the money owed will be deducted from my pay.
This application for employment is valid for the next 90 days. I understand that if I wish to be considered for employment after this period of time, I must apply again.
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