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General Application
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New Applicant Registration

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If you are a returning applicant, please sign in or reset your password using the Login button above.

Your Information

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Personal Information

How did you hear about us?

If you were referred by a SafeAuto employee please provide their name.

Additional Information

Have you ever worked for SafeAuto?

Have you ever been convicted of a felony involving breach of trust or dishonesty, for which you have not received a waiver from a state Department of Insurance?  Examples include fraud, theft, robbery, burglary, perjury, passing bad checks, embezzlement.  You should also answer “yes” to this question even if the felony conviction was later expunged.

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