First Name *

Last Name *

Email *

Phone *

Picture of You *

Upload Your Picture Here

Agency's Information

Agency Name *

If you do not have a logo, please insert your manager's Agency Name.

Agency Logo

If you have a logo, upload it here.

Admin's Information

If you do not have an admin, you can go to the next section.

Admin's First Name

Admin's Last Name

Admin's Email Address

Admin's Phone Number

Carrier Preferences

We recommend starting with American Amicable, Americo, Corebridge, Prosperity, and Mutual of Omaha.

Which carriers do you want your new recruits to contract with? *

Aetna

American Amicable

Americo

Corebridge

Ethos

Foresters

Manhattan Life (Health License Required)

Mutual of Omaha

TransAmerica

Are there any carriers you want your new recruits to contract with that are not listed above?

SRS Trainings

Do you want your new recruits to complete SRS Training during the onboarding process? *

Yes

SRS Trainings are required to request IUL and Annuity carriers.

XCEL Pre-Licensing Course

Do you have a XCEL pre-licensing course discount code? *

Yes

XCEL Course Discount Code

What is your XCEL pre-licensing course discount code?

Additonal Managers

Would you like to add other managers to your account?

Manager 1
Manager 2
Manager 3
Manager 4
Manager 5

These managers will be added to the new recruit form and will use your account for recruiting their agents.

System Notifications

Do you want you and/or your admin to receive notifications when your recruit/agent completes onboarding, licensing, and contracting steps? *

Yes

If you select "No", you will still receive updates that require manual action from you or your admin for your recruit/agent to move to the next step.

Notification Preferences

Who should we notify?

Manager

Admin

Both

Agree to Terms and Conditions

We look forward to you starting your own Velocity Agents CRM account. We will take the next 3-5 business days to get your account set up specifically for you and your team. Please email me if you have any questions along the way.

I agree to terms & conditions provided by the company. By providing my phone number and email address, I agree to receive calls, emails, and text messages from the business.