C.R. Ekern & Company
Webcasting Network

Consultative Brokerage Techniques
The Webcast Training Series

Enrollment Form

If you are ready to join our growing base of Consultative Brokerage Webcast subscribers, please complete and submit the following enrollment information.  This information will be used by C.R. Ekern & Company to set up your new account and provide the highest possible level of service to you and your firm.


Your Name

Your Firm

Your Title

Your email Address

Your Mailing Address

Your City

Your State

Your Zip Code

Your Phone Number

In which Webcast Training Series do you wish to enroll?

Total Number of Prodcuers in all locations of your firm (your subscription fee is calculated based upon the total of Property & Casualty, Benefits and/or Financial Services Producers in your firm at all locations at the time of your enrollment.  This number is subject to verification.)

Subscription Fee - Your Subscription Fee is calculated in accordance with the Pricing and Terms of our Agreement.  

Fee for First Producer (please complete)

Total of fees for additional producers (fee for each additional producer X total number of additional producers - please complete)

Total Fees for your Subscription (please complete)
(Important - You will be asked to enter this amount again on our secure online order page, so please make a note of this amount.)

Acceptance of Terms & Verification of Information

By submitting this form, you hereby state that you have reviewed and agree to abide by the Terms of this Agreement.  Furthermore, you declare that the information that you have provided on this form is accurate to the best of your knowledge.

Please click on the Submit button below to be transferred to our order page.  Note - You will be asked to provide the "Total Fees" amount (from above) again in order to properly process your order.

 

(Please be patient... This may take a few moments  Please do not press the Submit button more than once.  Thank you.)


Questions or Comments about our Webcast Services?  Please do not hesitate to contact us by phone toll-free at 888.670.1177 or email us at webcast@crekern.com.

Thank you.
C.R. Ekern & Company

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