Thank you for your interest to work in partnership with us. We would appreciate it if you could complete this application for our review. Our Intermediaries Relations Department will contact you soon on the status of your application.

APPLICATION FOR INDIVIDUAL AGENCY

About Yourself
1.
 Name of Applicant
2.
 Nationality
3.
 For non-Singaporean, please specify country of citizenship.
4.
 NRIC/Passport No.
5.
 Date of Birth
6.
 Mailing Address
7.
 Postal Code
8.
 Office Telephone No.
9.
 Residential Telephone No.
10.
 Mobile No.
11.
 Office Fax No.
12.
 Email Address
13.
 Highest Education Level
14.
 Do you possess a Certificate of General Insurance (CGI)? Yes  No
 
About Your Business Portfolio
1.
 Who is your existing Nominated Principal?  
2.
 Who is your existing Second Principal?  
3.
 Who is your existing Third Principal?   
4.
If you already represent three principals, which one do you intend to replace?
5.
 Your main reason for choosing Tenet: Recommended by 
Reason
6.
 Years of experience in insurance Years in General Insurance
Years in Life Insurance
7.
 Your business volume (inclusive of all your existing principals) in the last 2 years  
Year Business Volume (S$) Year Business Volume (S$)
2007, in General Insurance : 2007, in Life Insurance :
2008, in General Insurance : 2008, in Life Insurance :
8.
 Your projected business volume with Tenet for 2 years
          1st Year
          2nd Year
S$
S$
 9. Your projected business volume in these classes
  a. Personal Insurance
% %
  b. Business Insurance
% %
  c. Motor Insurance
% %
  d. Marine Insurance
% %
10. Please provide 2 business-related referees :
 
Name
Contact Telephone No.
Relationship
No of years knowing each other
a.
b.



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