Application For Employment

With The Get A Policy Now Insurance Group

First Name *

Last Name *

State Of Residency *

Phone *

Email *

Are you currently licensed to sell life insurance? *

Yes

No, but I'd like to get licensed

Are you currently licensed to sell health insurance? *

Yes

No, but I'd like to get licensed

Are you currently licensed to sell P&C Insurance? *

Yes

No, but I'd like to get licensed

How long have you been in the insurance industry? *

What states are you actively licensed to do business in? *

Do you currently hold active E&O coverage in place? *

Yes I do.

No, I need to get it.

No, working on it now.

Are you working with any other IMO or agency right now? *

Yes

What are you most excited about with this opportunity? *

Using ai to increase production

Training and gaining Experience

Helping families

The unlimited earning potential

Describe your ideal work setup *

Using ai automated systems to book appointments

Using ai + Calling leads

I'm old School, I like calling and door knocking

If given a system that generates leads, follows up, and books your calls — how would you spend your time?

What does success look like for you in the next 90 days?

Which of these describes you best? *

Goal-oriented with a strong sense of purpose

Entrepreneurial spirit and independence

Adaptability and technological fluency

Resilience and persistence

Strong interpersonal skills and client focus

By submitting this form, I agree to receive marketing text messages and phone calls from Purple Nana LLc DBA Get A Policy Now, including calls that may be automated, prerecorded, or use artificial intelligence (AI), at the phone number I provided. Message and data rates may apply. Message frequency varies. I understand that my consent is not required to purchase any products or services. I can opt out at any time by replying STOP to any text message or by contacting Get A Policy Now directly.

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