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LA Career Application

LA Insurance Application

Basic Information

Best time to contact you?
Best method to reach you?
Are you 18 years of age or older?
Can you provide proof that you are authorized to work in the United States?
Is this your first application with LA Insurance?
MM slash DD slash YYYY
Have you ever been employed by LA Insurance?
MM slash DD slash YYYY
Desired Shift


Prior experience in military service:


Are there hours or days when you are not available?
Do you have a valid, unrestructed, driver's license?
Have you ever been convicted of a felony?
Max. file size: 300 MB.

Authorization & Certification

This field is for validation purposes and should be left unchanged.