Field Adjuster recruiting form Step 1 of 4 - Page 1 25% Today's Date* MM slash DD slash YYYY (MM/DD/YYYY)What time zone are you located in?*Eastern (EST)Central (CST)Mountain (MST)Pacific (PST)AlaskaHawaiiYour 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 If you speak a language not listed above, please specifyHow did you hear about TelaClaims?*LinkedinReferred by friendFound onlineInstructed by employerOtherOther Source*Have you been a member of The US Armed Forces?* Yes No Have you ever worked for TelaClaims before?* Yes No Please specify what time period you worked with us.*For example: "I was a field adjuster during Hurricane Irma in 2017" Do you have an active adjusters license?* Yes No Primary Adjuster Licensed State*AlabamaAlaskaArizonaArkansasCaliforniaConnecticutDelawareFloridaGeorgiaHawaiiIdahoIndianaKentuckyLouisianaMaineMichiganMinnesotaMississippiMontanaNevadaNew HampshireNew MexicoNew YorkNorth CarolinaOklahomaOregonPuerto RicoRhode IslandSouth CarolinaTexasUtahVermontWashingtonWest VirginiaWyomingPrimary Adjuster License Number*Primary License Expiration Date (MM/YYYY)Enter your NPN (National Producer Number)Do you hold an adjuster's license in any additional states? If so, please select them below. Alabama Alaska Arizona Arkansas California Connecticut Delaware Florida Georgia Hawaii Idaho Indiana Kentucky Louisiana Maine Michigan Minnesota Mississippi Montana Nevada New Hampshire New Mexico New York North Carolina Oklahoma Oregon Puerto Rico Rhode Island South Carolina Texas Utah Vermont Washington West Virginia Wyoming How far are you willing to travel for claim assignments?*Up to 25 miles26-50 miles51-100 milesStatewide (Anywhere within my home state)Multi-state (Neighboring states)What year did your adjusting career begin?2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950Your Adjuster Level*No ExperienceJr. Adjuster (1-3 years)Adjuster (4-6 years)Sr. Adjuster (7-10+ years)Line of Business* Residential Commercial Flood Auto Other Please specify "Other" insurance related lines of business*Approximate number of Homeowners property claims handled:*Never handled a claim1 to 100101 to 500501 to 15001500+Approximate number of Commercial claims handled:*Never handled a claim1 to 100101 to 500501 to 15001500+Approximate number of Auto claims handled:*Never handled a claim1 to 100101 to 500501 to 15001500+ Have you ever worked as a carrier staff adjuster?*NoYesList all carriers that you have worked for and in what position/role.CarrierPosition/Role Carrier Certification(s) If ApplicableCertification NameExpiration Date (MM/YYYY) Do you have experience handling claims from inspection to file closure?* Yes No What estimating software(s) are you proficient in?* Xactimate Symbility Simsol Audatex Mitchell CCC Other Please specify "Other" estimating software(s) you are proficient in.*Please list Microsoft office applications you are proficient with: Microsoft Teams Word Excel Outlook None Do you have a National Flood Insurance Program (NFIP) License* Yes No National Flood Insurance Program (NFIP) License Number (If Applicable)License NumberExpiration Date (MM/YYYY)Do you have a Certificate from The California Earthquake Authority (CEA)?* Yes No California Earthquake Authority (CEA) License Number (If Applicable)License NumberExpiration Date (MM/YYYY)Do you have a Haag Roofing Certificate?* Yes No Haag 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, list 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?*YesNoDo you have an AR e Designation?*YesNoDo you have an AIM Designation?*YesNoDo 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 formatIs there anything else you'd like us to know? Δ
