Independent Agent Application

Apply to join Elite Insurance Group

A brief application so we get to know you. Takes about five minutes. We review every application personally and respond within one or two business days — usually faster. If we're a fit on paper, we'll send you an invitation to start the formal onboarding process.

About you

First name*

Last name*

Email address*

We'll send your invitation to this address if you're approved.

Phone number*

State you'd be licensed in*

Street address*

We need this for state licensing later. Won't be shared elsewhere.

City*

ZIP code*

Are you legally authorized to work in the United States?*

yesno

Are you 18 or older?*

Required to hold an insurance license in every state.

yesno

Experience

Do you currently hold an active insurance license in any state?*

yesno

If yes, which state(s) and line(s)?

E.g., 'TX General Lines P&C, since 2022'. Leave blank if not applicable.

Do you have prior sales experience?*

yesno

Briefly describe your sales experience (if any)

Insurance, real estate, retail, B2B, etc. Years and role are enough.

On a scale of 1–5, how familiar are you with insurance products?*

1 — Never thought about it before today2 — I've bought insurance, that's it3 — General understanding from research4 — Worked in or near the industry5 — Already an experienced agent

Availability and fit

How are you looking to work with us?*

Full-time / primary incomePart-time / secondary incomeSupplemental / side incomeJust exploring — not sure yet

Roughly how many hours per week can you commit to this?*

Do you have a quiet workspace, reliable internet, and a computer?*

This is a fully remote role.

yesno

Why are you interested in becoming an insurance agent with us?*

A few sentences is enough. We're trying to understand what's drawing you in.

How you heard about us

How did you hear about Elite Insurance Group?*

If you were referred, who referred you?

Their full name. Leave blank if not applicable.

I confirm that the information above is accurate, and I consent to being contacted by Elite Insurance Group at the email and phone number I provided regarding this application.

Training Academy Support Admin