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Become a Property & Casualty Agent What appointment(s) are you looking for today? Select all that apply. What appointment(s) are you looking for today? Select all that apply. Kemper Personal Insurance (including Mainstreet and Prime)? Kemper Auto - Non-standard Auto and Commercial Lines? Appointment & Insurance Type Information Appointment & Insurance Type Information Do you have a current Kemper Auto appointment? SelectYesNo Please List Your Producer Code What products do you need an additional market for? Select all that apply. What products do you need an additional market for? Select all that apply. Do you need an additional market for vehicle products? Select all that apply. Vehicles? Personal Auto Commercial Auto General Information About Your Agency General Information About Your Agency Agency Name Number of Offices Number of Employees Does your agency have a Commercial lines department? Does your agency have a Commercial lines department? Yes No How long have you been an Independent Agent/Broker? SelectLess than 1 year1-3 years3-5 yearsMore than 5 years Contact Information Contact Information First Name Last Name Job Title Address 1 Address 2 City State SelectAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming ZIP/Postal Code Phone Email Website Optional Helpful Information Optional Helpful Information Where did you hear about us? Where did you hear about us? Where did you hear about us? SelectDirect mailConventionComparative raterKemper sales representativeWebsiteCurrently appointed with sister companyPrevious employerReferralOther Please tell us how you heard about us. Please provide your top companies and annual premium estimates. Please provide your top companies and annual premium estimates. Company Annual Premium Company Annual Premium Company Annual Premium Please describe the use of comparative raters in your office(s). SelectAlways usedUsed by some employeesNever used Which raters do you use? Which raters do you use? EZ Lynx FSC Rater IBQ PL Rating ITC Other Please tell us what raters you use. Submit Leave this field blank Represent Our Life Business If you'd like to represent our Life line of business, please follow the links below. Become a Life Agent
