Please Fill Out the Form Below to Submit Your Job Application!
Name:
*
First Name
Middle Name
Last Name
E-mail:
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example@example.com
Date of Birth:
*
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Month
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Day
Year
Date
Phone Number:
*
Position you're applying for:
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Please Select
Agent/Broker
Admin/Operations
Marketing
How did you hear about us?
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Agent Referral
Word of Mouth
Google
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Education
Highest Level of Education Completed:
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High School Diploma or Equivalent
Some College or Associate's Degree
Bachelor's Degree
Master's Degree
Doctorate or PhD
Vocational or Technical Training
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Name of Institution:
Degree/Certification Earned (if applicable):
Expiration Date (Format: MM/YY):
Work Experience
Previous Employment History (list most recent first):
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Company Name: Job Title: Dates of Employment: Responsibilities:
Do you have any previous experience in the insurance industry? If yes, please provide details:
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Do you currently hold a valid FL 2-15 Health and Life License?
*
Yes
No
Skills and Qualifications
Please list any relevant skills or qualifications that make you suitable for this position:
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Motivation
Why are you interested in working with America First Healthcare?
*
What do you believe sets you apart from other candidates?
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Availability
Are you available to work full-time or part-time?
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Full-time
Part-time
Do you have any scheduling constraints we should be aware of? If so, please provide futher details:
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References
Please provide the names and contact information of three professional references:
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Name, Contact Number, and Relationship to Applicant
Additional Information
Is there anything else you would like our team to know about you or this application?
Preferred Interview Date
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Earliest Possible Start Date
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Year
Date
Cover Letter:
Please do not exceed 200 words.
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Signature
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Today's Date:
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