Affiliate Application | BestQuote Travel Insurance

Please provide the relevant information being asked for below. Once you've provided your information, your application will be reviewed and a copy of the Referral Arrangement Agreement sent to you to sign and return along with an image of your logo if you have one. We place your logo front and center on our site, so that you get the credit for helping your clients.

Corporate or tradename *

Which MGA are you associated with? *

Please provide the name of the MGA you are contracted with, or type none. This will not affect your compensation.

First Name *

Last Name *

Email Address *

Website

Mailing address *

Province *

City *

Postal Code *

Phone number *

Tax info

please put you SIN number, or Corporate Business number.

List of licensed provinces *

Please list all provinces you are licensed in and after each province include your (life,) accident and sickness license number).

List of insurers *

Please list all travel insurance providers you are currently contracted with, if none state 'none'

I have read and agree to the BestQuote Affiliate Referral Arrangement Agreement *

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