Hi there! Looks like you're interested in becoming a Beneplan preferred broker. Let's start by getting to know each other.
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Hey there! What's your first name? *

 
Last name? *

 
Daytime phone number? *

 
Thanks ! How did you hear about us?


 
Which license(s) do you carry? *


 
Can you supply a copy of your E&O insurance upon request? *

     
 
Which insurance or investment products do you distribute?


 
Do you prefer to work with MGAs, carriers directly, or a mix?


 
Are you willing to conduct an ethics quiz, to see if we're a good fit? *

     
 
In light of CASL, do you consent to receiving occasional communication from us? You can unsubscribe at any time. *

     
Thanks! One of our wholesalers will get back to you as soon as we can.
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