Peer Review Specialist 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 Licensed State*AlabamaAlaskaArizonaArkansasCaliforniaConnecticutDelawareFloridaGeorgiaHawaiiIdahoIndianaKentuckyLouisianaMaineMichiganMinnesotaMississippiMontanaNevadaNew HampshireNew MexicoNew YorkNorth CarolinaOklahomaOregonPuerto RicoRhode IslandSouth CarolinaTexasUtahVermontWashingtonWest VirginiaWyomingInfoAdjuster License Number Expiration Date MM slash DD slash YYYY What field do you have experience working in prior to practicing peer reviews?* No experience Water Restoration Fire/Smoke Restoration Mold Remediation Contamination Remediation Field Adjuster General Contractor Other Please Describe Other (If Applicable) What is your professional background prior to practicing peer review work?*What states do you service for peer review work?* Select All Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia 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 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 What year did you preform your first peer review?202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950Approximate number of homeowner peer reviews performed:*1-5051-100101-300301-500501+Approximate number of commercial peer reviews performed:*1-5051-100101-300301-500501+What estimating software(s) are you proficient in?* Xactimate Symbility Simsol Audatex Mitchell CCC Please list Microsoft office applications you are proficient with:* None Microsoft Teams Word Excel Outlook Do you have a Haag Roofing Certificate?*YesNoHaag Roofing Certificates License Number (If Applicable)License NumberExpiration Date (MM/YYYY) Do you have a Rope And Harness Certification?*YesNoDo you have a IICRC Certification? If so, select your active certifications.* Not Applicable AMRT (Applied Microbial Remediation Technician) ASD (Applied Structural Drying Technician) BMI (Building Moisture Inspection) CCMT (Commercial Carpet Maintenance Technician) CCT (Carpet Cleaning Technician) CDS (Commercial Drying Specialist) CPT (Contents Processing Technician) CRT (Color Repair Technician) FCT (Floor Care Technician) FSRT (Fire and Smoke Damage Restoration Technician) HCT (House Cleaning Technician) HST (Health and Safety Technician) ISSI (Introduction to Substrate and Subfloor Inspection) LCT (Leather Cleaning Technician) MRS (Mold Remediation Specialist) OCT (Odor Control Technician) RCT (Rug Cleaning Technician) RFI (Resilient Flooring Inspector) RFMT (Resilient Flooring Maintenance Technician) RRT (Carpet Repair and Reinstallation Technician) SCI (Senior Carpet Inspector) SMT (Stone, Masonry and Ceramic Tile Cleaning Technician) TCST (Trauma and Crime Scene Technician) UFT (Upholstery and Fabric Cleaning Technician) WFMT (Wood Floor Maintenance Technician) WLFI (Wood and Laminate Flooring Inspector) WRT (Water Damage Restoration Technician) 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: 15 MB, Max. files: 4. Please only upload your resume in PDF format Δ
