Employment Application

Piedmont Insurance is a dynamic, growth oriented organization that offers a variety of career opportunities. One of our core values is authenticity, and it begins with our talent selection process.

The following questions are designed to gauge your self-assessment of certain characteristics that may be suitable for a particular type of role. There are many roles, so there are no right or wrong answers, only accurate answers. Whether you are a veteran agent or brand new to the industry, our goal is to give you solid feedback, not only about your potential fit within our organization, but also insight as to which insurance related specialties may be most suited to your current experience.

At the end of this questionnaire, you will be able to upload your resume and a personal note (recommended).

Contact Information

Name(Required)

First Last

Email(Required)

Phone(Required)

How many years of experience do you have in any type of office or professional environment (sales, clerical, admin, customer service, etc)?(Required)

Please enter a number from 0 to 40.

Any experience specific to insurance?(Required)

Yes

How many years?

Please enter a number from 1 to 40.

Are you licensed?

Property & Casualty

Life

Health

Long Term Care

Investments and Securities

Choose the licenses you have in any state.

Do you have a current book of business?(Required)

Yes

Do you have a Non-Solicitation Agreement?(Required)

Yes

Any ‘insurance adjacent’ experience where your duties involved interaction with insurance policies, certificates, or language? (Finance, real estate, benefits, risk management, purchasing, etc)(Required)

Yes

Rank these statements 1-5, 1 being “Definitely not” and 5 being “Absolutely”.

Professional Preferences

I prefer the challenge of performance based positions, where I am pursuing prospects and customers and my compensation is primarily based on my individual achievement.(Required)