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Please choose at least 2 carriers from the list below. Print out the forms, fill them out as completely as possible. If you want to join the lead program then you will also fill out a credit card authorization for which lead programyou would like to join and fax it with your completed contracts along with a copy of your life license, errors and ommissions insurance (if required) and a voided check. Our FAX is (714) 729-0605.
You may email the forms to: corenteins@earthlink.net instead if you prefer. It takes approximately 2 weeks to become contracted with an agent number.
Following is a list of the carriers we offer.
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