Desk Adjuster recruiting form Step 1 of 3 - Page 1 0% Today's Date* MM slash DD slash YYYY (MM/DD/YYYY)Your Name* First Middle Last Suffix Business name (if applicable) Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Cell Phone*Email Address* Enter Email Confirm Email Date of Birth* MM slash DD slash YYYY Primary Language*EnglishSpanishFrenchChineseJapanesePortugueseArabicHindi-UrduBengaliItalianGermanRussianSwedishPolishPersianMalaysianTurkishDutchSwahiliTamilOtherAdditional Languages Spoken English Spanish French Chinese Japanese Portuguese Arabic Hindi-Urdu Bengali Italian German Russian Swedish Polish Persian Malaysian Turkish Dutch Swahili Tamil Other How did you hear about TelaClaims?*LinkedinReferred by friendFound onlineInstructed by employerOther (Please provide source)Other Source (If Applicable) Have you been a member of The US Armed Forces?* Yes No Have you ever worked for TelaClaims before?YesNo Do you have an active adjusters license?*YesNoPrimary Adjuster Licensed StateAlabamaAlaskaArizonaArkansasCaliforniaConnecticutDelawareFloridaGeorgiaHawaiiIdahoIndianaKentuckyLouisianaMaineMichiganMinnesotaMississippiMontanaNevadaNew HampshireNew MexicoNew YorkNorth CarolinaOklahomaOregonPuerto RicoRhode IslandSouth CarolinaTexasUtahVermontWashingtonWest VirginiaWyomingPrimary Adjuster License Number Primary License Expiration Date (MM/YYYY) List All Licensed States (Including Primary Home State) Alabama Alaska Arizona Arkansas California Connecticut Delaware Florida Georgia Hawaii Idaho Indiana Kentucky Louisiana Maine Michigan Minnesota Mississippi Montana Nevada New Hampshire New Mexico New York North Carolina Oklahoma Oregon Puerto Rico Rhode Island South Carolina Texas Utah Vermont Washington West Virginia Wyoming What year did your adjusting career begin?*202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950Your Adjuster Level*No ExperienceJr. Adjuster (1-3 years)Adjuster (4-6 years)Sr. Adjuster (7-10+ years)Line of Business* Property Commercial Flood Auto Other Please list other insurance related lines of business (If Applicable) Approximate number of Homeowners property claims handled:*Never handled a claim1-100100-500501-15001500+Approximate number of Commercial properety claims handled:*Never handled a claim0-100100-500501-10001000+Approximate number of Auto claims handled:*Never handled a claim0-100100-500501-10001000+ Have you ever worked as a carrier staff adjuster?*YesNoList all carriers that you have worked for and in what position/role. (If Applicable)CarrierPosition/Role Carrier Certification(s) (If Applicable)Certification NameExpiration Date (MM/YYYY) What estimating software(s) are you proficient in?* None Xactimate Symbility Audatex Mitchell CCC Other Please list Microsoft Office applications you are proficient with: None Microsoft Teams Word Excel Outlook Do you have a CPCU Designation?*YesNoPartialDo you have a Juris Doctorate Degree?*YesNoBy selecting this box, you authorize TelaClaims Adjusting LLC to remit your information for a full background check and share your resume as needed.* I agree to the privacy policy.Your information may be shared with insurance carriers for possible job opportunities. By selecting this box, you authorize TelaClaims Adjusting LLC to send you emails regarding upcoming job opportunities and updates. This is how we will stay in contact with you.Please upload your current resume.* Drop files here or Select files Accepted file types: pdf, Max. file size: 25 MB, Max. files: 4. Please only upload your resume in PDF format Δ
