Online Employment Application

Please fill out the questionnaire below to submit your employment application.

* Required Fields

POSITION DESIRED/AREA(S) OF INTEREST

Sales/Marketing  Clerical/Secretarial  Administration	Information Systems  Other, please describe:
Full time	Part time
Pay Desired

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PERSONAL INFORMATION

* Full Name	* Street Address
	* City, State, Zip
* Home Telephone	Work Telephone
* Email:

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COVER LETTER

(Optional)

RELATED SKILLS & TRAINING

Please list any skills or training relevant to the positions you desire (languages, leadership training, supervisory, office, computer, etc.)

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EMPLOYMENT / EXPERIENCE

Name of Most Recent/Current Employer

Starting Date		Ending Date

Job Title

Responsibilities:

Reason for Leaving:

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Previous Employer

Starting Date		Ending Date

Job Title

Responsibilities:

Reason for Leaving:

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EDUCATION

Name & Location of School	Select Last Year Completed	Major Course	Diploma/Degree
High School
	Select... 9 10 11 12		Yes  No
College/University
	Select... 1 2 3 4 More		Select... Bachelors Masters Doctorate Other None
College/University
	Select... 1 2 3 4 More		Select... Bachelors Masters Doctorate Other None
Business or Trade School

I acknowledge and understand that submission of my online employment application does not require Southeastern Insurance Agency, Inc. to offer me employment. Click the Submit Application button to send your request:

Southeastern Insurance Agency, Inc. Website Privacy Policy Southeastern Insurance Agency, Inc. is committed to providing quality service to meet all the needs of our website visitors. One of the newest and fastest growing delivery channels is the Internet. A concern arising from the rapidly changing world of technology and specifically the Internet, is your right to maintain privacy. We assure you that we share your concerns and are committed to ensure that all information you supply us is held in strictest confidence. Visitors to Southeastern Insurance Agency, Inc.'s website will remain anonymous. We do not collect personal identifying information about visitors to our site. If you provide identification (such as name and address) via email or online form, or ask for information, the information provided will only be used to communicate with you to handle your request. It is not sold or transferred to other parties. Our servers only collect standard non-identifying information about visitors to the site, such as date and time visited, IP address, city, state and country. This information is used to compile standard statistics on site usage.