in Chicagoland

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Employment Application

Answer all questions completely. We are Equal Opportunity Employer. No question on this application is intended to be discriminatory under any applicable Federal, State or Local Fair Employment Practices Law.


    I. Personal Information

    II. Employment Interests

    III. Education Information

    IV. Skills

    V. Employment Information

    Start with Current or Most Recent Employer.

    Company 1

    Company 2

    Company 3

    VI. Acknowledgment

    I authorize any person, school, current employer (except as expressly noted), past employer(s), and organizations named in this application form (and accompanying resume or other documentation, if any) to provide ATLANTIC INSURANCE AGENCY with relevant information and opinion, personal or otherwise, that may be useful in making a hiring decision. I release all parties from all liability from any damage that may result from furnishing information and opinion to you.

    In consideration of employment, I agree to obey the rules and standards of ATLANTIC INSURANCE AGENCY. I understand that nothing contained in this application or in the interview process is intended create a contract between ATLANTIC INSURANCE AGENCY and myself for either employment or for the providing of any benefits. I agree that my employment is at-will and the terms of employment may be changed with or without cause, with or without notice, including but not limited to termination, demotion, promotion, transfer, compensation, benefits, duties and location of work, at any time, for any reason, at the option of myself or ATLANTIC INSURANCE AGENCY. This constitutes my entire agreement with ATLANTIC INSURANCE AGENCY with regard to the length of my employment.

    I understand that as a condition of employment I may be required to take a post-offer/pre-employment physical examination that may include an alcohol and drug test. I further understand that at any time during my employment, I may be required to take a physical examination which may include an alcohol and drug test if management reasonably suspects a condition exists that will prevent me from performing my job in a manner that does not endanger my own health or the safety and health of others. I authorize all providers of health care who examine me to disclose to ATLANTIC INSURANCE AGENCY or its agents, all medical information revealed during such examinations. I further authorize ATLANTIC INSURANCE AGENCY to disclose such information to any other persons, if at any time my medical condition is put at issue in any proceeding by myself or others. In the event that I have credibility that will affect my ability to take the test, I will so inform ATLANTIC INSURANCE AGENCY so that a reasonable accommodation can be made. ATLANTIC INSURANCE AGENCY reserves the right to require medical documentation concerning the need for accommodation.

    I understand that all offers of employment are conditioned upon my providing satisfactory documentary proof of my identity and legal right to live and work in the United States.

    I hereby acknowledge that I have read the above statements and understand them. I certify that I, the undersigned applicant, have personally completed this application. I declare under penalty of perjury that the facts contained in the application (or any resume or other documents submitted) are true and complete to the best of my knowledge. I understand that any misrepresentations or omissions will disqualify me from further consideration for employment, and will be justification for my dismissal from employment, if discovered at a later date.

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    Real Clients. Real Reviews.

    Liliana at Atlantic great customer service I loved it..shes always been there for me since Day it shes a keeper,shes friendly she does things quickly and really her service...

    Daliana Ramirez

    This worker in Atlantic Insurance is amazing Liliana Roldan is fast at working and she convinced me to pay my price and i got really good offers.

    Ashley Ramirez

    Called in to get coverage for my daughter’s first car while at the dealership, Liliana is GREAT! Did everything via email, she gave us a couple of options and helped decide the best coverage for my daughter. Highly recommend Liliana at Atlantic, great customer service and speedy service!

    Michelle Cruz

    Liliana was amazing!! She helped me with all my troubles and she found me the best price for my car insurance! price and her respond was Better than in all other companies! I am so grateful for that and I recommend this company for everyone, and always ask for Lily! She is the sweetest person i ever met! best regards!

    George Krkeljic

    Liliana is the absolute sweetest ! She’s very quick to reply with emails and extremely helpful. She makes purchasing insurance very easy. If I could give her 100 stars I would.

    Aida Agic

    Contact Us Today!

    ATLANTIC Insurance Agency
    5356 W. Belmont Ave
    Chicago, IL 60641