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Please choose 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 program you 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 most of the carriers we offer.
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