New agency (brokerage)

New agency application

Thank you for your interest in joining us as a sales partner! Use this application to apply for a contract with Prevea360, and establish an account to appoint multiple agents under your agency.

If you are seeking appointment through the account of an agency or brokerage that has an existing contract, please see our Agent Appointment form. If you are a sole proprietor or independent agent, please see our Sole Proprietor form.

Our sales leadership team review all applications for new contracts. If approved, your contract will go into effect the month you submitted your application.

Required attachments to upload with application

  • W-9
  • EFT authorization form
  • Voided check or other bank document for commissions payment
  • Declarations page of current Errors & Omissions policy

Have questions or need help? Email us at agentlicensing@prevea360.com or call us toll-free at 877-317-3046

Application form

 *Required

Have you attached all the proper documents to this application? Your application will not be processed without all of the proper documentation that is needed with this request.