The Cincinnati Insurance Companies | New Agent Program Nomination Form

New Agent Program Nomination Form

Program Date To Attend

Candidate's Name

Candidate's Email Address

Agency Name

Agency Code

Your Sales Field Representative

Contact Name

Contact Email Address

How long has your candidate been employed at your agency?

Please describe candidate's current job responsibilities:

Is your candidate licensed to sell insurance?

Please list any prior insurance training your candidate has had:

Does your candidate have prior experience working with The Cincinnati Insurance Companies?

Please describe your candidate's prior insurance experience, if none, please state "none":

Has your candidate had any prior sales experience?

Who is your candidate's mentor within your agency? This is a person who has an active interest in the candidate's development.

Mentor's Name

Mentor's Position in Agency

Mentor's Email Address

Is there any additional information about your candidate you feel is important for us to know?