Careers

Unruh Insurance Employment Form

Interested in starting a Career at Unruh Insurance? Fill out the form below and we will respond to you as soon as possible!

Personal Information

First Name

Middle Initial

Last Name

Address

City

State

ZIP

Primary Phone

Secondary Phone

Type of Employment Desired

Position Desired

Wage Desired:

Date You Could Start Work.

Type of Position
If part-time, number of hours:
If temporary, please explain:

Are you available to work overtime? Yes No

Are you able to work weekends? Yes No

What hours do you prefer to work: Day Night Other

Education and Training

School Level	Name and Location	No. of Years Completed	Degree, or Certificate	Major
High School
College/University
Vocational/Technical
Other

Skills and Qualifications

What skills, special training, licenses and/or certificates do you have related to the job for which you're applying?

Indicate your skills in the following areas. Include software titles for computer skills.

Word Processing

Spreadsheet

Data Entry

Presentation

Internet

Phone

Customer Service

Public Speaking

Accounting

Payroll

Other(s)

List professional, business, or civic activities (Exclude organizations which reveal race, color, religion, sex, national origin, age, veteran status, disability or other protected status):

Employment History

(Most recent employer first; Account for all periods of time, including Military service)

Employer Name

Job Title

Address

Employment Dates

City, State, Zip

Wage

Supervisor Name

Reason for Leaving

Describe Duties

Employer Name

Job Title

Address

Employment Dates

City, State, Zip

Wage

Supervisor Name

Reason for Leaving

Describe Duties

Employer Name

Job Title

Address

Employment Dates

City, State, Zip

Wage

Supervisor Name

Reason for Leaving

Describe Duties

May we contact your present employer? Yes No

May we contact all other employers? Yes No

If No, please explain:

Have you ever been dismissed or been forced to resign from any position? Yes No

If Yes, please explain:

Have you worked or attended school under another name? Yes No

If Yes, please explain:

Professional References

Give the names of three persons not related to you, whom you have known at least one year.

Name	Title and Relationship to You	Telephone Number

General Information

Have you ever applied for employment with our agency before? Yes No

If Yes, when?

Have you been employed by our Agency in the past? Yes No

If Yes, when?

Do you have a relative who works here? Yes No

If Yes, please explain:

Are you authorized to work in the United States?
Yes No

Proof of Citizenship or Immigration status will be required upon employment.

Are you 18 years of age or older? Yes No

Please Read Carefully Before Signing

In consideration of employment by the Agency, I agree to abide by the rules and regulations of the Agency which may be changed from time to time at the sole discretion of management. I declare each of the answers I have given in the employment application to be complete and true to the best of my knowledge. I understand that any false information may disqualify me from further consideration for employment and may result in my discharge from employment if discovered at a later date.

I understand that as a condition of employment I must be authorized to work in the United States and demonstrate that authorization as required by the Immigration Reform and Control Act of 1986.

Further I understand that employment may be contingent upon successful completion of:

a) A background check that may include, but is not limited to, criminal record*, motor vehicle record, previous employment, education and personal references;

b) Successful completion of a pre-employment, post-offer medical screening and/or medical test for alcohol, drugs, or controlled substances.

I understand that this application or subsequent employment does not create an employment contract nor guarantee employment for any defined period of time. Further, I understand that my employment is "at will" and can be terminated by either me or the Agency at any time for any reason or for no reason, except as provided in an alternative bona fide employment employment agreement.

I have read, understand and by clicking submit agree to the above statements.

Email Address

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Downtown Denver

Unruh Insurance Agency, Inc.
335 Main Street
Denver, PA 17517
P: 717-335-2929 | F: 717-335-2923

Mon. – Fri. : 8:00 am – 5:00 pm
Sat. : 9:00am - 12:00pm

Shady Maple Complex

Unruh Insurance Agency, Inc.
1344 Main Street
East Earl, PA 17519
P: 877-854-3309 | F: 717-351-5431

Mon. – Fri. : 8:00 am – 5:00 pm
Sat. : Closed