Huntsville Day News

American US Insurance Employment Application Welcome to our Online Employment Application! If you are a qualified individual with a disability or a disabled veteran, you have the right to request a reasonable accommodation if you are unable or limited in your ability to use or access our online application as a result of your disability. You may request reasonable accommodations by contacting Human Resources at [email protected]. Applicant Information Full Name Date Last First Middle Address Apartment/Unit # Street Address City State ZIP Phone Email Date Available Desired Salary Yes No Are you authorized to work in the US? Yes No Have you ever worked for this company? If yes, when? Yes No Are you currently employed? Yes No May we contact your current employer? Position Desired Education High School Did you graduate? Address Yes No Degree College Address Did you graduate? Yes No Degree Other Address Did you graduate? Yes No Degree References Please list three professional references. Full Name Relationship Company Phone Address Full Name Relationship Company Phone Address Full Name Relationship Company Phone Address Previous Employment Company Address Phone Supervisor Job Title Starting Salary$ Ending Salary$ Responsibilities From To May we contact your previous supervisor for a reference? Yes No Company Address Phone Supervisor Job Title Starting Salary$ Ending Salary$ Responsibilities From To May we contact your previous supervisor for a reference? Yes No Military Service Yes No Are you a veteran? Branch Rank at Discharge Start Date End Date Skills List professional skills and certifications. Please exclude any medical information. Criminal History Disclosure Yes No Have you ever been convicted of a felony? If yes, explain Agreement I certify that my answers are true and complete to the best of my knowledge. I understand that false or misleading information in my application or interview may result in my release. I understand that I am required to abide by all rules and regulations of the employer. Furthermore, I understand that this application is not a contract of employment and that I am required to acknowledge in writing that my employment is at-will. Yes No By checking yes, I agree to the above terms and conditions Typing your full name acts as an electronic signature Full Name Submit