Application for Employment
Coastal Claims is an equal opportunity employer. Coastal Claims does not discriminate in employment with regard to race, color, religion, national origin, citizenship status, ancestry, age, sex (including sexual harassment), sexual orientation, marital status, physical or mental disability, military status or unfavorable discharge from military service or any other characteristic protected by law.
Include your last seven (5) years of employment history, including periods of unemployment, starting with the most recent and working backwards in
time. Incomplete information could disqualify you from further consideration.
Give the names of three persons not related to you, whom you have known at least three (3) years.
Please read carefully before signing
I understand that neither the completion of this application nor any other part of my consideration for employment establishes any obligation for Coastal Claims Services to hire me. If I am hired, I understand that either Coastal Claims Services or I can terminate my employment at any time and for any reason, with or without cause and without prior notice. I understand that no representative of Coastal Claims Services has the authority to make any assurance to the contrary.
I attest with my signature below that I have given Coastal Claims Services true and complete information on this application. No requested information has been concealed. I authorize Coastal Claims Services to contact references provided for employment reference checks. If any information I have provided is untrue, or if I have concealed material information, I understand that this will constitute cause for the denial of employment or immediate dismissal.
THIS APPLICATION IS VALID ONLY FOR 60 DAYS FROM THE DATE ABOVE.