Big I MD - IMPACT Maryland Interest Form

Big I MD - IMPACT Maryland Interest Form

Complete the form below to be added to our contact list
IMPACT Maryland is a vibrant community for emerging and aspiring insurance professionals throughout the state. Open to all roles—whether you're licensed, new to the industry, or simply looking to connect—IMPACT Maryland is dedicated to providing meaningful opportunities for professional growth, relationship building, and leadership development.

Our mission is simple but powerful:
To cultivate and empower the next generation of insurance professionals by fostering leadership, education, and mentorship.

Who qualifies for IMPACT Maryland?

IMPACT Maryland is open to insurance professionals, licensed or not, who are under the age of 40 OR have been in the business less than 5 years.

Membership is not limited to agents only; it is open to anyone involved in or supporting the insurance industry, including all agency and company personnel.
Name*

First NameLast Name
Agency/Company Name:*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Format: (000) 000-0000.
E-mail*
I have been in the insurance industry less than 5 yearsI am 40 years old or younger
By submitting this form, you consent to receive communications from Big I Maryland regarding education updates, product updates, programs, and functions updates, and IMPACT correspondence to the email address above.
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