The Move Hiring Submission Form

If you would like a form that pre-populates your information to save you time then click here.

First Name (or the name they go by)*

Last Name*

Phone Number*

Email*

Please note that @hotmail.com emails sometimes filter out or delay important emails from us and the insurance companies. If no other email is available, please pay close attention to this agent to ensure they are getting the Affidavit, Onboarding, and SureLC emails. For most reliable results, we recommend creating an @gmail.com account.

Hiring Manager Name (This is you)*

Hiring Manager Phone (This is you)*

Hiring Manager Email (This is you)*

Hiring Manager NPN (This is you)*

Which team are you on?*

Additional Notes*

Licensed or Unlicensed*

LicensedUnlicensedStudying For Exam

Submit Contracting For...

Life OnlyHealth OnlyLife and Health

Will you be the agent's direct upline?*

YesNo

Agent Upline*

Agent Upline Phone*

Agent Upline Email*

Agent Upline NPN*

Comp Level*

You are submitting to hire this agent at {compLevel}%

If that is incorrect please change now before submission

Agent Submission Form