Become an eLife Marketer

Attention Call Centers and Database/ Internet Marketers:

We are now pleased to offer a new Simplified Term Life Issued by HSBC. To learn more about adding this new and ground-breaking product as well as our other services, please complete the form below. You will be contacted in approximately 1 business day.

Contact Information:
				- Select State -
Brief Questionaire:
	Select your company type:			- Select - Call Center Database Marketer Other
	How long have you been in business?			- Select - Less than a year 1 year 2 years 3 years 4 years 5 years 6 years 7 years 8 years 9 years 10 years Over 10 years
	How much in annual premiums do you write in a year?			- Select - < $50,000 $50,000 - $100,000 $100,000 - $250,000 $250,000 - $500,000 $500,000 - $1,000,000 > $1,000,000 > $5,000,000
	What is your primary market?			- Select - Annuity Auto Life & Health Long Term Care Property & Casualty Other
	Who are your primary life insurance carriers?
	AIG American General RBC Insurance West Coast Life Genworth Financial Prudential Other ING Transamerica
	How many states are you licensed in?			- Select - 1 - 10 States 11 - 20 States 21 - 30 States 31 - 40 States 41 - 48 States All States
	Do you currently sell a Simplified Issue Product?			Yes No
	Colonial Penn Fidelity Gerber Globe Liberty Life Other
	Would you be interested in any other marketing services?			- Select - No Yes
	Referral Code
	Comment