Schafer, Wood & Associates Application

SCHAFER, WOOD & ASSOCIATES APPLICATION
All qualified applicants will receive consideration for deployment without regard to race, religion, color, national origin, sex, age, status as protected veteran, among other things, or status as qualified individual with disability.

Notice to Applicants: The following matters will generally restrict an applicant from deployment with SWA (This is not an exclusive list): Any conviction involving breach of trust (lying, cheating, stealing, etc.); any conviction involving violence; any conviction for bad checks or other evidence of mishandling of money or finances; any conviction of a felony; any pending felony charges; any outstanding warrant; lack of valid driver's license.

Please note: All deployments are temporary in nature & compensation is determined by event.
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- I have read the above and wish to proceed with the application.*

Please list below any adjuster's license you presently have.

State	License Number	Expiration Date	License	Actions

There are no Licenses.

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Direct Deposit Authorization
I authorize Schafer, Wood & Associates to initiate automatic deposits to my account at the financial institution named below. In the event that Schafer, Wood & Associates deposits funds erroneously into my account, I authorize Schafer, Wood & Associates to debit my account for an amount not to exceed the original amount of the erroneous credit.

This agreement will remain effective until Schafer, Wood & Associates receives a written notice of cancellation from me. I also understand that completing this section allows a photocopy, fax copy, or copy sent by email of this authorization to be valid as the original.
Name(s) on Account*
Name of Financial Institution*
City*
State*
Country*
Routing Number*
Account Number*
Account Type*
- Checking
- Savings

Disclosure Statement
Pursuant to the Violent Crime Control and Law Enforcement Act of 1994, 18 U.S.C. §1033(e), an individual may not engage in the business of insurance if the individual has been convicted of a felony involving dishonesty or breach of trust, unless the individual has the written consent of an appropriate insurance regulatory official.
Have you ever been convicted of a felony?*
- Yes
- No
Date of Conviction*
MM slash DD slash YYYY
Court*
City*
State*
Describe in detail the conviction and criminal act:*
Type of punishment or penalty received as a result of the conviction:*

Document Upload
Please submit the following documents.
Note: Please upload with unique filename.
Drivers License*
Accepted file types: jpg, jpeg, png, pdf, doc, docx, tiff, Max. file size: 10 MB.
Self-Portrait Photograph*
Accepted file types: jpg, jpeg, png, tiff, Max. file size: 10 MB.

Please follow these guidelines.
Resume*
Accepted file types: doc, docx, pdf, Max. file size: 10 MB.
Passport
Accepted file types: jpg, jpeg, png, pdf, Max. file size: 10 MB.
Miscellaneous Files Upload
Drop files here or

Accepted file types: jpg, jpeg, png, pdf, doc, docx, Max. file size: 256 MB.
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- I certify the information I have provided to be true to the best of my knowledge.
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- I have read and agree to the Terms & Conditions.
× Please note: After submitting your application, you will be redirected to sign digitally the following documents: Inquiry Release, W9 Form & Consulting agreement. This might take a up to a minute, DO NOT refresh the page.

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Application