New Producer Form

Appointment of New Producer


First Name:
Last Name:
E-Mail Address that invite needs to be sent to:	(if this is not the producer e-mail address, please supply)
Producer Email Address:
Agency Name:
CWG^® Agency Number (if available):
Your personal invite will come from agency_licensing@cwgins.com with a subject line of "Your Invitation to Contract with CWG^®." Please add this to your safe list to avoid any spam filters. This message will be sent to the CWG^® Agency Licensing department. They will correspond with your producer when they receive it.

	Message:

** CWG^® will be sending a personal invite to the new producer for their licensing information which will include home address, Social Security Number, Date of Birth and state and national license numbers in which is needed to make the appointment for them to place business with CWG.

Note: This form does NOT serve to register you in our on-line agency portal. This form is for purposes of beginning the appointment process with your respective state Department of Insurance. Once appointed, the agency administrator in your agency can Set Up the producer for agency portal access.