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Authorised Representative Application Form
Application for new AR’s
Name
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Last
Email
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Please leave a brief history of your career in insurance.
Education Level
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Diploma Insurance Broking
ASIC PS 146 Tier 1
Other
Insurance book
(Required)
I am starting from scratch
I have a pre-existing book
Insurance Experience
(Required)
I have more than 2 years Australian based business insurance Broking Experience
I have less than 2 years Australian based business insurance Broking Experience
Book Income
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What is the value of the books income?
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