1-888-280-5225 Home Underwriting Services Insurance Claims Loss Prevention Agent Resource Center Policyholders Careers Forms Contact Pay Online Employment Application THIS APPLICATION IS NOT AN EMPLOYMENT CONTRACT but merely is intended to evaluate suitability for employment. It is the policy of the company to provide equal employment to all qualified persons without discrimination on the basis of sex, race, color, religion, age, national origin, citizenship, disability, veteran status, or any other status protected under local, state or federal law. It is also the policy of the company to have the option of conducting pre-employment screening before a job offer is made. If a job offer is made, employment may be contingent upon the successful completion of a pre-employment drug screening and/or medical examination. This application will remain active for 30 days. Your Personal Information Position you are applying for:* Your Name* First Last Your Email Address* Enter Email Confirm Email Your Home Address* Street Address Unit / Suite Number City State Zip Code Education Please indicate your highest level of education completed:* High School Associate Degree Bachelor's Degree Graduate or Professional Degree Other High School School City State Degree Area of Study College School City State Degree Area of Study Other School School City State Degree Area of Study Your Phone* Best Time To Call You* When is the best time for us to reach you via telephone? Best Time To Call You Mornings Early Afternoon Late Afternoon Early Evening Are you at least 18 years of age and authorized to work in the United States?* Yes No Have you worked for Lackawanna Insurance Group before?* Yes No Do you have a valid driver's license?* Yes No Are you currently bound by a noncompetition, confidentiality or trade secret agreement?* Yes No Employment History Please list your current and/or previous employers for the past 10 years below.* Employer Dates Position Phone Job Related Skills Use this space to list any special skills you have that relate to the position you are applying for.* List any professional licenses, designations, certifications, etc. that may relate to the position you are applying for.* Upload Your Resume (Optional) Accepted file types: pdf, doc, docx, Max. file size: 100 MB. upload your resume in .pdf, .doc or .docx format Disclaimer and Signature I certify that all information I have provided in order to apply for and secure work with this employer is true, complete, and correct. I understand that this employer does not unlawfully discriminate in employment and no question on this application is used for the purpose of limiting or eliminating any applicant from consideration for employment, it will be necessary for me to reapply and fill out a new application. I understand that this application remains current for only 30 days. At the conclusion of that time, if I have not heard from the employer and still wish to be considered for employment, it will be necessary for me to reapply and fill out a new application. If I am hired, I understand that I am free to resign at any time, with or without cause and with or without prior notice, and the employer reserves the same right to terminate my employment at any time, with or without cause and with or without prior notice, except as may be required by law. This application does not constitute an agreement or contract for employment for any specified period or definite duration. I understand that no supervisor or representative of the employer is authorized to make any assurances to the contrary and that no implied oral or written agreements contrary to the forgoing express language are valid unless they are in writing and signed by the employer’s president. I also understand that if I am hired, I will be required to provide proof of identity and legal authorization to work in the United States and that federal immigration laws require me to complete an I-9 Form in this regard. This Company does not tolerate unlawful discrimination in its employment practices. No question on this application is used for the purpose of limiting or excluding an applicant for consideration for employment on the basis of his or her sex, race, color, religion, national origin, genetic information, citizenship, age, disability, or any other protected status under applicable federal, state or local law. This Company likewise does not tolerate harassment based on sex, race, color, religion, national origin, citizenship, genetic information, age, disability, or any other protected status. Examples of prohibited harassment include, but are not limited to, unwelcome physical contact, offensive gestures, unwelcome comments, jokes, epithets, threats, insults, name-calling, negative stereotyping, possession or display of derogatory pictures or other graphic materials, and any other words or conduct that demean, stigmatize, intimidate, or single out a person because of his/her membership in a protected category. Harassment of our employees is strictly prohibited, whether it is committed by a manager, coworker, subordinate, or non-employee (such as a vendor or customer). The Company takes all complaints of harassment seriously and all complaints will be investigated promptly and thoroughly. I understand that any information provided by me that is found to be false, incomplete, or misrepresented in any respect will be sufficient cause to (i) eliminate me from further consideration for employment, or (ii) may result in my immediate discharge from the employer’s service, whenever it is discovered. CAPTCHA Acceptance* I agree to the Terms and Conditions Home Pay Online Agent Resource Center Careers Report an Injury Contact Lackawanna Insurance Group 46 Public Square Suite 501 Wilkes-Barre, PA 18701 Contact Local: 570.824.1400 Toll Free: 888.280.5225 Fax: 570.824.1913 © Lackawanna Insurance Group | Web Design & Hosting by Acadia Systems Web Design & Hosting | Protected by AcadiaBackup