Search Criteria Form

What will you need from enroller candidates?

*Company Name:

*Your Name:

Phone:

*Email:

*Describe Your Needs
(What products or services will be communicated or sold)

*What Area of the Country Will You Need
(If you have zip codes in Excel, please provide)

* Will Enrollers Need to be

Licensed
Have errors and omissions insurance

* Bilingual:

Yes
No

* How do you anticipate paying enrollers

Per Diem
Commission
Other - Please List