Employment Application

Select the kind of work that would best suit you:

Permanent  Temporary 
I would accept a temporary position that could lead to a permanent position

Tell us about you:

Name:
Address:
City:
State:
Zip: 
Day Time Phone
Evening Phone:
Your Email Address:
Position Desired:
Salary Desired:

Check Areas of Interest: (check all that apply)

Commercial Lines CSR  Commercial Lines Agent 
Personal Lines CSR  Clerical  
Systems / Automation  Data Entry 
Accounting Receptionist


Education (please give all levels of education including trade schools):

Employment History (please list company, contact and duties for your past two employers)

Computer Experience (please list all software applications and if they were PC or Mac platform)

Describe your professional licenses, designations and training

We appreciate your interest in the Walton Agency, Inc. and we look forward to working with you to attain your professional goals.

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