Submit App – AgentTraining.info

Date

Who's Your Agency Manager?*

Are you splitting this with another agent?

App split (put your % as the first number)*

Note: if you are doing an app split, you must select how much the split is above.

Agent Name*

First Last

Agent Email*

Cell Phone*

Who's The 2nd Agent's Manager?*

2nd Agent Name*

First Last

2nd Agent Email*

Client Name*

First Last

APV (annual premium volume)*

Insurance Company*

Do you have an agent number with this carrier?*

Please check box below to continue*

I understand that my application will not be sent to the carrier by submitting it on agenttraining.info and that I need to upload it in Opt! when I create the transmittal page. I also understand filling in the above information and clicking submit is a necessary step to complete the entire Upload an Application process in order for my applications to get to all the necessary insurance companies, departments, and for my numbers to be recorded, in order to receive my promotions.

Note: The submit button will not appear unless all the fields are filled out correctly.