Catastrophe Employment Application
Contact Information
First Name Address 1
M.I. Address 2
Last Name
City
Phone 1 State
Phone 2 Zip Code
Fax Country
Email  
Employment History
Do you have earthquake claims experience?
Yes     No
Do you have a Passport?
Yes     No
List your history as follows (Please list most recent employer first):
- Dates employed
- Name of employer
- Employer's address
- Your position and duties

Example: 1997-Present, ABC Adjusters 1982-1997 XYZ Adjusters Property Adjuster, worked property claims which included taking proofs, recorded statements, non-waivers and completing caption reports.

List your certifications
Examples: NFIP, CPCU, IIA, State Farm, FWUA, etc.
List any licenses that you hold
List State, Type and expiration date
Education
Most recent first
Expertise (select all that apply)
Property
Casualty
Auto Appraisal
Heavy Equipment
Workers Comp