Registration Form for a New Broker
To become a Sportscover Accredited Broker, there are a number of criteria that your company must fulfil including areas such as Information Technology, Complaints Procedures, Geography, Credit history and References. Please complete the following registration form to be submitted to the Underwriting Panel for consideration.
Completion of this form is an Application only and does not guarantee accreditation.
Broker Name
Contact Name
Broker Address
Broker Suburb
Broker Postcode
Broker Country
Contact Address
Contact Suburb
Contact Postcode
Contact Country
Telephone (Home)
Telephone (Business)
Fax
Email Address
Internet Site
(example: http://www.sportscover.com)
Are you a member of a broker group? Yes No
If yes, which group?
What Sports and leisure
business do you currently have?
What Sports and leisure business
are you targeting in the next 12 months?
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