Agent Onboarding — Join Our Team

Personal information

First name *

Last name *

Phone *

Email *

Home state * The state where you are based

City

Date of birth * Used for internal records and reminders

Full address

Licensing & credentials

NPN number * Find yours at nipr.com — required

Resident state license #

Years of experience * Enter 0 if new to insurance

E&O expiration date Errors & Omissions insurance

States you are licensed in *

Select every state where you currently hold an active insurance license — this is stored separately from your home state above

Verticals — select all that apply *

Life Insurance Annuity Medicare Advantage Med Supp MSA

Carriers — select at least one *

Additional information

Current book size (approx. clients)

How did you hear about us?

Anything else we should know?

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You're in the pipeline!

Your information has been submitted and we'll be in touch within 24 hours about next steps for contracting and onboarding.