PILOT EMPLOYMENT APPLICATION
Pilot Catastrophe Services is an affirmative action/equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, age, status as a protected veteran, among other things, or status as a qualified individual with disability.Read more information about your rights under equal employment opportunity laws.
This employment application is used by Pilot and all of its affiliated and/or subsidiary companies. Do not leave any items unanswered.
Notice to Applicants: The following matters will generally restrict an applicant from working for Pilot (This is not an exclusive list): conviction involving breach of trust (lying, cheating, stealing, etc.); conviction involving violence; conviction for bad checks or other evidence of mishandling of money or finances; conviction bearing on the fitness for the job; outstanding warrant; lack of a valid driver's license; under the age of 19; work as property or auto insurance agent or ownership of an insurance agency within the last 12 months.
For what position are you applying?
What are your salary expectations?
If hired, when could you start work?
Are you legally eligible for employment in the United States?
How did you hear about our company?
List any criminal history that might prevent your employment within the insurance industry.
List the names of people you know who work for Pilot.
Driver License #:
State of Issue:
Do you have a current and valid Insurance Adjuster’s license in your home state or a designated home state?
Have you ever, or are you currently working, as a claims adjuster?
Do you have at least 2 years of related experience working in the construction or automotive industry?
|Employer||Title||Start Date||End Date|
|Name||Degree||Major||Years Completed||Academic Achievements||City||State|
Select a category from the list below to specify which skills apply to you.
|Additional Living Expenses|
|Commercial Roof Certification|
|HAAG Engineering Certification|
|NFIP Large Commercial|
|NFIP Mobile Home|
|NFIP Small Commercial|
|Pilot Safety Property Cert.|
|Property Total Loss|
|Roof Calculating & Inspection|
|State Farm Certified|
|Wind Effect on Structure Certification|
|Wood Roof Certification|
|GM Corp Certification|
|Heavy Equipment Claims|
|Liability Auto Adjuster|
|Pilot Safety Auto Cert|
|All Lines of Adjusting|
|Customer Service Claims|
|Farmers Staff Adjusting|
|OSHA Safety Course|
|SF Staff Adjusting|
|State Farm Certified|
|Alabama Adj. License|
|Alaska Adj. License|
|Arizona Adj. License|
|Arkansas Adj. License|
|California Adj. License|
|Colorado Adj. License|
|Connecticut Adj. License|
|Delaware Adj. License|
|Florida Adj. License|
|Georgia Adj. License|
|Hawaii Adj. License|
|Idaho Adj. License|
|Indiana Adj. License|
|Kentucky Adj. License|
|Louisiana Adj. License|
|Maine Adj. License|
|Maryland Adj. License|
|Michigan Adj. License|
|Minnesota Adj. License|
|Mississippi Adj. License|
|Montana Adj. License|
|Nevada Adj. License|
|New Hampshire Adj. License|
|New Mexico Adj. License|
|New York Adj. License|
|North Carolina Adj. License|
|Oklahoma Adj. License|
|Oregon Adj. License|
|Pennsylvania Adj. License|
|Rhode Island Adj. License|
|South Carolina Adj. License|
|Texas Adj. License|
|Utah Adj. License|
|Vermont Adj. License|
|Washington Adj. License|
|West Virginia Adj. License|
|Wyoming Adj. License|
|Claims Management System|
|EZ LINER Chief Certification|
|FAST Est. Comp Experience|
|IMANET Computer Experience|
|Mitchell Est. System|
|NADA Total Loss Program|
|National Contraction Estimator|
|Pro Estimating Software|
|Real Estate Background|
|Small Business Owner|
- General Adjusting
- Other Employment
Equal Employment Opportunity Employer
Pilot provides equal employment opportunities (EEO) to all employees and applicants for employment and does not discriminate on the basis of race, religion, color, sex, age, national origin, disability unrelated to ability to perform job duties, marital or veteran status (including Vietnam-era or special disabled veteran status), or any other legally protected status in accordance with all applicable laws governing nondiscrimination in employment at every Company facility. This policy extends to all terms and conditions of employment including, but not limited to, hiring, promotion, termination, layoff, recall from layoff, transfers, developmental and educational opportunities, leaves of absence and compensation.
To further the principle of equal employment opportunity within our Company and to comply with governmental regulations, Pilot has developed Affirmative Action plans for minorities, women, the disabled and Vietnam-era and special disabled veterans. The below requested applicant data is used by Pilot to comply with government recordkeeping, reporting and other legal requirements.
Your cooperation in providing this information is voluntary. This information is maintained separately from all other employment-related documents. The information or lack of information requested on this form will not affect employment decisions.
Social Security Number:
Voluntary Self-Identification of Disability
Why are you being asked to complete this form?
Because we do business with the government, we must reach out to, hire, and provide equal opportunity to qualified people with disabilities. To help us measure how well we are doing, we are asking you to tell us if you have a disability or if you ever had a disability. Completing this section is voluntary, but we hope that you will choose to fill it out. If you are applying for a job, any answer you give will not be used against you in any way.
How do I know if I have a disability?
You are considered to have a disability if you have a physical or mental impairment or medical condition that substantially limits a major life activity, or if you have a history or record of such an impairment or medical condition.
Disabilities include, but are not limited to:
- Bipolar Disorder
- Major Depression
- Multiple Sclerosis (MS)
- Missing limbs or partially missing limbs
- Cerebral palsy
- Muscular Dystrophy
- Post-Traumatic Disorder
- Obsessive Compulsive Disorder
- Impairments requiring the use of a wheelchair
- Intellectual Disability (Previously called mental retardation)
NOTICE TO ALL APPLICANTS: IT IS IMPORTANT THAT YOU READ THE SECTION BELOW PRIOR TO EXECUTING THIS APPLICATION.
This certifies that this application was completed by me, and that all entries on it and information in it are true and complete to the best of my knowledge. By executing and submitting this application, I certify that I am genuinely interested in working in the position(s) for which I have applied and am making this application for no other purpose. I understand that any misrepresentation or omission is grounds for immediate termination of employment or refusal to hire.
I understand that Pilot will conduct an investigation into my employment qualifications and fitness for employment. I hereby consent to have an investigation made by Pilot. I also authorize and request every person, company, governmental agency, schools and/or institutions having control of any documents, records, and other information pertaining to me to allow Pilot to inspect and copy any such documents and records. I agree to release Pilot and its agents and representatives, and any person or entity furnishing oral reports and any written documents and records, or other information from any and all liability that may result from furnishing this information. I also agree to sign separate documentation authorizing Pilot to obtain a consumer report on me for employment purposes.
I agree to confirm the policies, procedures, rules, and regulations of Pilot. I also agree that my employment is at-will and can be terminated at any time by me or Pilot, with or without cause and with or without notice. I further understand that no one employed by Pilot has the authority to enter into any employment agreement for any specified duration or to make any agreement contrary to the foregoing.
I understand that Pilot may employ knowledge, skills, and abilities testing in its employment process and that employment with Pilot will be contingent upon the successful completion of such tests. If required for my job classification, I understand that my employment will be contingent upon the successful completion of a post-offer employment physical examination and/or drug and alcohol screening. I agree that the results of these tests may be released to Pilot. I understand that I may also be required to undergo drug and/or alcohol testing at other times if I am employed by Pilot.
NOTICE TO ALL APPLICANTS: IT IS IMPORTANT THAT YOU READ THE SECTION BELOW PRIOR TO SIGNING AND DATING THIS APPLICATION
Applicant and Pilot have agreed that Applicant will complete and execute his or her application by electronic means and that Pilot will accept delivery of the application by electronic means. Execution of the application shall be accomplished through electronic means by the individual's typing his or her name in the place provided for the signature of the Applicant. The Applicant further acknowledges that he or she adopts the typing of his or her name in the place provided as part of the application as his or her signature for purposes of electronic completion of the application.
Thank you for submitting your application.
Please review required fields.