Adjuster Application

by canhailMar 26, 2019

Interested in joining our Crop Hail Adjusting team?

Please fill out and submit the form below. We will be in touch with you as soon as possible.

Name*
First Last
Residential Address*
Street Address Address Line 2 City Province Postal Code
Phone*
Fax
Mobile
Email*
Name of Business (if any)
Business Address
Street Address Address Line 2 City Province Postal Code
Business Phone
Business Fax
Have you ever held an adjusters license anywhere in Canada?*
- Yes
- No
Please provide information about the license year, class and jurisdiction.*
Has any adjuster license held by you ever been suspended or revoked anywhere in Canada?
- Yes
- No
Have you ever been refused an adjusters license anywhere in Canada?*
- Yes
- No
Are you currently, or do you plan to engage in any business other than the adjusting business?*
- Yes
- No
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