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Home > Online Employment Application
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Online Employment Application


Incomplete applications will not be processed.  This application will be considered active for 180 days.  Any applicant wishing to be considered beyond this time period should submit another application.

Please note, this application is intended for use in evaluating your qualifications for employment.  This is not an employment contract.  Please answer all questions completely and accurately.  False or misleading statements on this form are grounds for termination of the application process, or, if discovered after employment, termination of employment.  Additional testing of job-related skills or for the presence of illegal drugs in your body may be required prior to employment.


Applicant Information
First Name *
Last Name *
Street *
City *
State *
ZIP / Postal Code *
Primary Phone Number *
E-Mail Address *
Position Information
Which position are you interested in?
Comments
Desired Salary
Willing to relocate?

Full-Time or Part-Time employment?

If Part-Time, how many hours per week are you available?
What date are you available to start?
/ /
Are you at least 18 years of age?

Citizenship Information
Are you prevented from being lawfully employed in this country due to a Visa or immigration status?

Education Information
High School Name
City
State
Receive High School Diploma?

College/University
City
State
How many years of college have you completed?
What is/was your course of study?
Please list all other schooling
Job Related Skills
Which agency management system(s) are you familiar with?




Working knowledge of Microsoft products? Check all that apply.



List knowledge of other computer programs:
List any other skills:
List any licenses or certifications you have that would be of value to this job or company
Security
Have you ever been bonded in prior employment?

Have you ever been convicted of a misdemeanor or a felony? *

If Yes, please explain
Background Authorization
If I am interviewed and accept employment, I agree to allow Texas Associates to investigate my background

Employment Experience
Please go back 5 years, listing your most recent employer first. Include any gaps in employment and state the reason for no employment during this period
Employer
Address
City
State
Zip
Phone
Job Title
Supervisor
Start Date
End Date
Starting Salary/Hourly Wage
Ending Salary/Hourly Wage
Reason for Leaving
____________________________________________
Employer
Address
City
State
Zip
Phone
Job Title
Supervisor
Start Date
End Date
Starting Salary/Hourly Wage
Ending Salary/Hourly Wage
Reason for Leaving
____________________________________________
Employer
Address
City
State
Zip
Phone
Job Title
Supervisor
Start Date
End Date
Starting Salary/Hourly Wage
Ending Salary/Hourly Wage
Reason for Leaving
Upload resume
Submission Validation
Required

Important Notice
Any submissions or payments made via this website do not constitute a binding agreement to your policy or coverages. Changes and payments to policies are not effective or binding until you, or any party involved, receive official notice from either your insurance agent, or your insurance company. If you have any questions, please feel free to contact us.

Per the terms of our online privacy policy we will not resell your information to any third-party.
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Contact Info

Texas Associates Insurors - Home Office
1120 Capital of Texas Hwy
Bldg 3-300
Austin, TX 78746

Ph: 800.765.4154
Ph: 512.328.7676
Fax: 512.327.8337

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