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Employee Benefits Counselor Survey
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1.
Your full name
(Required.)
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2.
Your preferred email address
(Required.)
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3.
A good phone number where we can reach you
(Required.)
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4.
Do you currently hold an active Life and Health Insurance license?
(Required.)
Yes
No
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5.
Which language(s) are you fluent in? (Select all that apply)
(Required.)
English
Spanish
Vietnamese
Haitian Creole
French
Other (please specify):
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6.
How many years of employee benefits enrollment experience do you have?
(Required.)
No employee benefits enrollment experience
Less than 1 year
1-2 years
3-5 years
5+ years
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7.
Would you be available to work full-time from October 12, 2026, through November 20, 2026?
(Required.)
Yes
No
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8.
Are you willing to travel for enrollment assignments, if needed?
(Required.)
Yes
No
Depends on the assignment
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9.
Which best describes your communication style?
(Required.)
I enjoy taking the time to educate and answer questions thoroughly.
I prefer to communicate efficiently and keep conversations brief.
I adjust my communication style based on the person's needs.
I prefer written communication over verbal conversations.
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10.
How did you hear about us?
(Required.)
Facebook
LinkedIn
X
From a friend or acquaintance (please provide their name below)
Other (please explain below)
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