Home Platinum Membership Request


If you have already registered with us and would like to apply for platinum membership, please fill out this form so we can evaluate your request. Platinum membership is a very exclusive service. Only our top producers gain access. You will be provided with your global password once your membership is authorized. If you are not already a regular member, click here to sign up for a regular membership. Regular membership allows you to preview many of the AFS web site features.

* - Denotes Required

Username:*
Password:*
Name:*
The following profile assists us in tailoring services to meet your practice.*
How would you describe yourself?
I would rather work than not.
Work is important, but I have other priorities.
I'm at that stage now where I have other strong interests besides work.
 

It's important for me to succeed in my career.
I have already reached a level of success but want to take it to the next level.
I have already achieved what I set out to achieve and now I have other targets in my sights.
 
I am not interested in how the watch works.
I need to know how the watch works.
   
I like having a team support me.
I am the team.
   
I respond well to good coaching.
I feel like I can coach others very well.
What I want help with most is:*
When I receive information from you, I:*
Like as much detail as possible.
Rely just on the proposals and brochures.
Look forward to the educational material all the time.
Your Primary or Target Market:*
Current Primary Carriers:*
Verifiable 1099s for last tax year from this business:*
Breakdown of Business:*
% Annuity
% Life
% LTC
% Other
What marketing methods do you use?
Advertising
Seminars
Direct Mail
Telemarketing
Referral
Other
What companies are you contracted with now (please list them so we don't duplicate)?*
Which products have you written in the last six months?*
Are there marketing companies, BGAs or producer groups through whom you presently write business?*
Yes
No
If so, please list them:
What do you like most about them?
Do you recruit?*
Yes
No
If yes, how many agents do you work with now?
BONUS: Share the word. Are there any colleagues that might be interested? What are their names and e-mail addresses?
 

< Back


More Info
Upgrade to: Member | Platinum

Copyright © 2000-4, Annuity Financial Services, All Rights Reserved. Disclaimer
Copying or use of text or images located on this web site without express permission is prohibited.
For Broker Use Only. Not for solicitation of General Public. All plans and riders may not be available in all states.