Contact Information
Have you ever been convicted of a felony?
Do you have computer experience
Do you own or are you willing to purchase a laptop with access to the internet/email to complete the duties of this position?
Do you have the applicable adjuster license(s) for the applicable state(s)?
Education

Please list name, location, and diploma/degree for each attended.

Previous Experience
Do you have previous Crop Adjusting experience?
Are you able to accept assignments on short notice?
Do you have the ability to accept electronic data (email)?
Are you willing to accept assignments that require travel away from home?
Are there times during the season when you would be unable to work?
Can you perform the duties of a crop adjuster?

Such as, but not limited to climbing bins, walking in fields or working outdoors.
Do you currently have an adjusting contract with any other companies?
References

Reference 1

Reference 2

Reference 3

Certification and Release

I certify that the answers given by me to the foregoing questions and the statements made by me are complete and true to the best of my knowledge and belief. I authorize all persons, schools, companies and law enforcement authorities to release any information concerning my background and hereby release any said person, schools, companies and law enforcement authorities from any liability for any damage whatsoever for issuing this information.

I also understand that any services provided by me would be as an independent contractor, and not as an employee of the Company and would therefore not qualify for unemployment compensation. In addition, I assume all responsibility with respect to the payment of federal/state taxes as a self-employed individual.

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