Abbey Insurance Services, Inc.         Application for Employment

You are submitting this application to Abbey Insurance Services Alpharetta location.

Please enter all the information correctly and concisely.  Submitting this form to an improper location will delay the reviewing process.  Please allow 24-48 hours for your application to be reviewed by an Abbey representative.  If you do not hear from an Representative in that time, please contact us to follow-up.

You will need to fill in all information that you are asked for. After you submit the form, you should be taken to a thank you page. If you are not, or the form reappears then you have not filled in all of the required information.

GENERAL INFORMATION

Send this resume to

Last Name First Name  Middle Initial Email

SS #   Date

Address Suite/Apt #

City    State     Zip    Home #    Other #

Work #  Can we contact you at work?       When can you Start?

Position Desired  

Have you ever worked for Abbey Insurance before?   _____ Which location? 

EDUCATION

High School Name    City   State   

Year Graduated?

University/College/Trade School Name   

City   State     Major    Degree    

Year Graduated?  

Special skills and Qualifications?

EMPLOYMENT HISTORY (Start with most recent employment)

Employer Name    City   State   How Long?

Position/Title   Reason for Leaving   Salary

Description of Duties:
 

May we contact your present employer?

Supervisor    Title

Employer Name    City   State   How Long?

Position/Title   Reason for Leaving   Salary

Description of Duties:

Employer Name    City   State   How Long?

Position/Title   Reason for Leaving   Salary

Description of Duties 

Please list Memberships, Organizations, or Special Qualifications that may contribute to your employment with Abbey Insurance Services?

REFERENCES

Name    Occupation                

Address Suite/Apt #

City   State    Zip      Home #       Work #   

Years Known?   (check if ok to contact them at work)       

Name    Occupation                    

Address Suite/Apt #

City   State    Zip      Home #       Work #   

Years Known?   (check if ok to contact them at work)    

Name    Occupation <              

Address Suite/Apt #

City   State    Zip      Home #       Work #   

Years Known?   (check if ok to contact them at work)

I certify that all of the information listed on this application is correct and true to the best of my knowledge.  I understand that any false information given may be grounds for immediate refusal of this application, and denial for employment with Abbey Insurance Services, Inc.  Please select yes to accept, or no to deny the terms of submitting this application.

Yes, I agree with the terms      No, I do not agree with the terms   

Upload Resume (Microsoft Word .doc format only!)    

To send your application now--->

Form created by Digidot Design for Abbey Insurance Services, Inc.
Copyright © 2003 Abbey Insurance Services, Inc.  All rights reserved.
Revised: -->March 14, 2003