NextGEN Agent Partnership Application

To get the conversation started, please answer the following questions. Thank you for your interest in this opportunity.

Full Name*

First NameLast Name

E-mail*

Phone Number*

State of Residence*

YesNo

In which states are you currently licensed?*

Less than 1 year1 - 3 years3 - 5 years5+ years

YesNo

Under 2020 - 3030 - 4040+

Describe your current insurance business or role.*

(Where you’re at today — not where you want to be)

What does a productive workday look like for you when you’re working remotely?*

What types of insurance products have you sold, and which have you had the most success with?*

How have you primarily generated leads or new business in the past?*

What are you looking for in your next agency or partnership?*

Describe a time you had to rebuild, pivot, or push through a difficult period in your career. What did you do?*

How do you define success for yourself over the next 12 months?*

I understand this is not a salaried positionI am comfortable being accountable for my own resultsI am willing to participate in weekly training and collaboration