1. I have read and I understand the complete description of your program.
2. I understand that I am receiving access to the 10 items listed in the “GENERAL AGENT” Package and not just the 20 weekly “RESPONSE” leads.
3. I understand I will receive online access to the 10 items listed in the "GENERAL AGENT" Package within one business day.
4. I understand I will receive the "Response" leads (20 per week for up to 12 weeks based on the amount of PRIMARY carriers I selected above) via EMAIL beginning in approximately 7-10 BUSINESS DAYS. I understand I must be eligible to contract with or transfer with the carrier for it to count towards the free leads.
5. I understand that I will receive the leads that I selected on my sign up form and that I cannot change my order once I start receiving my free leads.
6. I understand that I should follow the instructions provided with the leads in order to generate the maximum amount of appointments.
7. I understand that it is my responsibility to notify “National Annuity and Life Sales” within 10 business days if my leads are not received and that “National Annuity and Life Sales” is not responsible for my leads being deleted or placed in a spam folder by my email service provider.
8. I understand that the 20 weekly “RESPONSE” leads are just one part of the “GENERAL AGENT” Package and are meant to be a supplement to the other items in the “GENERAL AGENT” Package.
9. I understand I should implement some of the other 10 lead programs to take full advantage of your program along with qualifying for your “FIRST APP” Promo.
10. I understand I must execute a new or transfer an existing contract with one of your listed insurance carriers before receiving access to these 10 items.
11. I understand that if I am declined contracting or not approved with at least one of your carriers, I will not receive the 20 weekly leads.
12. NALS is making an initial investment in your business by providing you with our leads along with access to our exclusive copyrighted material, training and lead programs at NO cost to you. Therefore we expect an honest effort on your part to work the leads and programs as instructed and attempt to place a portion of your business with the carrier(s) you contracted with through NALS . For our protection and to prevent abuse of our leads and programs, NALS does not provide contract releases within the first six months of joining our program.
13. I understand this program is for my use only and may not be copied or distributed to any other persons.
14. I understand that the “up to 12 weeks of leads” contracting offer is ONLY good at time of sign up and that if I decide to add carriers to NALS at a later date that it DOES NOT add extra weeks of leads to the offer.
15. I understand that I am an independent contractor and that my commissions are paid directly from the insurance carriers. All Commissions are paid upon issue and delivery of policy, not submitted.
16. I understand that the “First APP” Promo becomes available upon my first submitted case. For carriers that do not process agent contracts UNTIL the first submitted case, then I understand that I MUST be APPROVED by that carrier before the case is considered submitted. I also understand that an incomplete app or an app that has any missing documents will NOT be considered submitted UNTIL all missing documents are received from the agent.
17. I understand that the 20 weekly leads, direct mail leads and telemarketing leads are all provided by a 3rd party insurance lead vendor and not generated or provided directly by NALS. NALS assumes no responsibility for the accuracy or quality of the leads.
18. I understand that after I submit this application, I must sign then fax or mail the signature pages on the next page to National Annuity and Life Sales to complete the contracting process or I will not receive access to the "GENERAL AGENT" Package and leads.
19. The “First App” promo or any other program, incentive or promotion offered by “National Annuity and Life Sales” is only valid to our agents in good standing. (No current Letter of Intent to transfer or agent debt with us).
20. NALS offers UP TO 9 months advanced commissions on most carriers for Life and Final Expense products based on the following: 1. All NEW agents to NALS will be offered 6 month advanced commissions to start and can be raised to a 9 month advanced after 120 days based on production and quality of business with us. 2. Any NEW agents to NALS that provides proof of last 12 months of paid-for life premium of at least $25,000 with a persistency ratio of at least 75% will be offered 9 month advanced commissions instead of 6 month. 3. Any agents with bankruptcies in the past two years, current major credit issues or any outstanding agent debt with other carriers may not qualify for our advanced commission program. Agents will be placed at as-earned commissions only to start and can be raised to a 6 or 9 month advanced after 120 days based on production and quality of business with us.
21. I understand that if I add the website hosting and live quoting engine option, that the set up cost and monthly hosting fees paid are non-refundable if I cancel.
22. I have reviewed the commission schedules on page 4 and agree to the terms.

I have read and I understand the complete description of your program and agree to the terms above.

How did you hear about us? (Please check one)
Yahoo search Google search Other search Agents Sale Journal
Life Selling Magazine Senior Advisor Magazine Post Card
Phone call E-mail Another Agent / (Referring Agent name)=
Other I am a current member

We are always looking to help agents succeed. If you know any agent you would like us to share this opportunity with, please list them below and we will send them an information kit. If any agent you refer to us signs up for our program, we will send you a free $20 gift card per agent once they submit their first case with any one of our carriers.
NameEmail or Phone
NameEmail or Phone

Questions or Comments



*Once you hit submit, you will be forwarded to our "Online Contracting Page" to complete your carrier(s) contracting paperwork that you selected above. Once we receive your signed carrier contract(s), we will submit to our carrier(s) for verification. This can take up to the next business day. Once we receive verification, we will:

- Email you an ID and Password to access our "GENERAL AGENT" Package agent website for complete information and material.
- Order your FREE weekly "Response" leads. Your first set of leads will be emailed within 7-10 days.