1. I have read and I understand the complete description of your program.
2. I understand that I am receiving the 9 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 9 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 carriers I selected above ) via EMAIL beginning in approximately 7-10 BUSINESS DAYS.
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 you within 10 business days if my leads are not received and that you are 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 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 these 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. Our company 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 us. For our protection and to prevent abuse of our leads and programs, we do 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 us 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” Promoe 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 us. We assume 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 us to complete the contracting process or I will not receive The "GENERAL AGENT" Package and leads.
19.
The “PRODUCING AGENT” programs or any other program, incentive or promotion offered by us is only valid to our agents in good standing. (No current Letter of Intent to transfer or agent debt with us).
20. I have reviewed the commission schedules and agree to the terms.
I have read and I understand the complete description of your program and agree to the terms above.
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(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.
Name
Questions or Comments
*You will be forwarded to our "Contract Signature Page" to print out and fax your completed paperwork. Once we receive your signed forms, we will submit to our carrier(s) for verification. This can take up to the next business day. Once we receive verification, we will: 
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