Careers & Partnerships w/National Brokers Group
General Application
Full Name
*
Email Address
*
example@example.com
Mobile Phone
*
City & State
*
TCPA Compliance Consent
*
Preferred Contact Method
*
Email
Phone
Text
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Which role are you applying for?
*
Please Select
Independent Life Insurance Broker (1099)
Onboarding Coordinator (Admin)
Marketing Coordinator (Insurance)
Technical Support Specialist (CRM/MarTech)
Vendor / Partner Submission (3rd-Party)
How did you hear about us?
*
Please Select
Social Media
Referral
Job Board
Event
Other
Upload Resume / Work History
*
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Do you have a Life/Health license?
Yes
No
License States
National Producer Number (NPN)
Tell us about your experience
*
Work Type
*
Please Select
Full-Time
Part-Time
Contract
Partnership (Vendor)
Preferred Start Date
*
-
Month
-
Day
Year
Date
Willing to get licensed in 30 days?
*
Yes
No
Authorized to work in the U.S.?
*
Yes
No
E&O Coverage in force?
Yes
No
Background Check Consent
*
Yes
No
Carriers written with?
Communication Consent
*
Approx issued premium last 12 months
Product lines sold
Final Expense
Mortgage Protection
IUL
Fixed Annuities
Indexed Annuities
Medicare
Comfortable with Zoom + eApps?
Yes
No
Schedule & availability notes
Years of admin/HR experience
Tools used
Google Workspace
Monday.com
GoHighLevel/AgentCRM
JotForm
ClickSend
Comfortable with spreadsheets?
Yes
No
A time you improved a process
Comfortable on phone with agents?
Yes
No
Years of marketing experience
Marketing skills
Social Posts
Email/SMS Copy
Canva
Landing Pages
Pixel QA
Reporting
Portfolio/links
Platforms used
Meta Ads
Google Ads
GA4
Tag Manager
Sample ad copy
Years in IT/MarTech
Systems supported
Monday.com
GoHighLevel/AgentCRM
ClickSend
Make/Zapier
Calendly
Deliverability knowledge
DNS
SPF
DKIM
DMARC
10DLC
Example troubleshooting
Comfortable running office hours
Yes
No
Company Name
Website
What do you offer?
Please Select
Leads
AI/Voice
Training
Marketing Services
Compliance
Other
2–3 sentence pitch
Upload Deck / One-Pager
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Pricing model & tiers
Compliance posture
TCPA
10DLC
HIPAA/PHI
SOC2
KPIs you can measure
30-day pilot available?
Yes
No
W-9 ready?
Yes
No
Submit
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